Long-term stability of a patient-convenient 1 mg/ml suspension of tacrolimus for accurate maintenance of stable therapeutic levels

Bone Marrow Transplantation
A ElefanteP L McCarthy

Abstract

Tacrolimus (Prograf, FK506, Fujisawa Healthcare) is a widely used immunosuppressive agent that is used both for the prevention and treatment of solid organ transplant rejection as well as for the prevention and treatment of graft-versus-host disease after allogeneic blood and marrow transplant. Oral preparations of tacrolimus are commercially available in 0.5, 1 and 5 mg gelatin capsules. Previously, only a 0.5 mg/ml oral suspension has been demonstrated to be stable for use in pediatric patients. On our bone marrow transplant service, we found that using this concentration of tacrolimus led to confusion, with patients and their caregivers confusing milligrams and milliliters, thus increasing errors with this formulation. We postulated that a 1 mg/ml oral formulation of tacrolimus would decrease the potential for medication errors. Our findings support new stability information of approximately 4 months for an extemporaneous oral suspension of tacrolimus at a concentration of 1 mg/ml.

References

Jan 15, 1997·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·P A JacobsonJ A Foster

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Citations

Aug 18, 2012·Blood·Nathaniel TreisterLeslie Lehmann
Sep 4, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Nathaniel TreisterRobert Soiffer
Apr 22, 2014·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Tiene BautersJohan Vandenbroucke
Jan 30, 2015·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Catherine A Pennington, Jeong M Park
Jan 16, 2019·Proceedings of the Japan Academy. Series B, Physical and Biological Sciences·Naoki Yoshida
Jun 5, 2018·Cancer Nursing·Simone Pereira LermontovMagali Rezende de Carvalho
Sep 5, 2020·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Adam B CochraneRobert L Page

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