Tacrolimus is also a calcineurin inhibitor and it's interpretation is complex. Trough levels may vary depending on the clinical scenario, such as illness or type of transplant, concomitant immunosuppression, time post-transplant and dosage regime.
For further information the appropriate clinical team/s looking after the patient should be contacted
As a guide for interpretation of tacrolimus levels see suggested thresholds from the Post-Operative Care in the Kidney Transplant Recipient BTS/UKRA Guidelines 2017:
- Simulect induction - Adoport to blood trough level: 8-10 ug/L up to 3 months, 5-8 ug/L after 3 months
- Campath induction with graft factors - Adoport to blood trough levels 5-8 ug/L
- Campath induction - non standard risk (high risk) - Adoport to blood trough level 8-10 ug/L up to 6 months, 5-8 ug/L after 6 months
An additional consideration is that mistiming of sampling in relation to medication can cause unexpected high/low levels of tacrolimus and are not true trough levels
Information on safe prescribing of tacrolimus can be found here
See TDM information.
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