Tacrolimus dose requirement in renal transplant recipients is significantly higher when used in combination with corticosteroids

Aims: To evaluate the effect of corticosteroids on tacrolimus pharmacokinetics. Methods: In a randomized trial, kidney transplant recipients were treated with tacrolimus and mycophenolate mofetil with either daclizumab (n = 31) or 3 months of prednisone (n = 34). Tacrolimus dose-adjusted predose concentrations (Co) at month 1-6 were compared between both groups and within the corticosteroid group before and after prednisone withdrawal. Results: At month 1 the tacrolimus dose-adjusted C0 in the corticosteroid group was 83 ± 8 vs 119 ± 17 ng ml-1 mg-1 kg-1 in the daclizumab group. The tacrolimus dose-adjusted C0 within the corticosteroid group at month 1 and 2 was 42% and 29% lower compared with month 4 (P < 0.001). Conclusions: A higher tacrolimus dose is required to reach target concentrations when used in combination with corticosteroids.

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