Summary

This AI-generated content is provided without warranty, with no liability accepted for reliance on it. Learn more.

• Tacrolimus (Prograf) is indicated for the prophylaxis of organ rejection in adult and pediatric patients receiving allogeneic liver, kidney, heart, or lung transplants, in combination with other immunosuppressants.
• The information was derived from 14 systematic reviews/meta-analyses studies focusing on tacrolimus' safety and effectiveness compared to other immunosuppressants.
• Neurologic adverse effects such as tremor, headache, and insomnia were inconsistently correlated with tacrolimus trough concentrations; older age and female gender (especially Black females) showed higher incidences of these side effects.
• Pharmacokinetic variability limits therapeutic drug monitoring's ability to prevent toxicity effectively; developed algorithms improved target concentration ranges but did not significantly reduce toxicity compared to bodyweight-based dosing.
• No significant differences were found between once-daily versus twice-daily tacrolimus regimens regarding clinical outcomes like acute rejection rates or patient mortality in renal transplant patients.
• Combining mTOR inhibitors with reduced tacrolimus exposure appears safer than calcineurin inhibitor avoidance or early steroid withdrawal regimens which show increased rejection rates.
• Genetic polymorphisms such as CYP3A4*22 influence plasma concentrations and dose requirements for tacrolimus; personalized dosing based on genetic markers may improve safety and efficacy profiles over standard practices.