Tacrolimus Toxicity With Minimal Clinical Manifestations: A Case Report and Literature Review

American Journal of Therapeutics
Nivin HaroonZeenat Yousuf Bhat

Abstract

Tacrolimus (FK 506 or Fujimycin) is an effective anti-T-cell agent derived from the fungus Streptomyces tsukubaensis. Some in vitro studies have demonstrated that the potency of tacrolimus can be up to 100 times to that of cyclosporine. Despite being a very potent immunosuppressant, its use is complicated by narrow therapeutic range, individual variation in pharmacokinetics, and a broad spectrum of drug interactions. We report a case of very high tacrolimus level (>120 ng/mL) in a patient who was on antiretroviral medication and tacrolimus. Despite having such high drug levels, patient's clinical presentation and course was benign. He was managed conservatively and this ordeal resulting in no long-term sequela.

References

Apr 1, 1992·Immunology Today·S L Schreiber, G R Crabtree
Apr 1, 1994·The Annals of Pharmacotherapy·M A Hooks
Oct 27, 1994·The New England Journal of Medicine·UNKNOWN U.S. Multicenter FK506 Liver Study Group
Jun 1, 2000·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·G FillerB Hocher
Jul 15, 2005·Kidney International·Santiago Lamas
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Neeraja KambhamMinnie M Sarwal
Dec 21, 2007·The New England Journal of Medicine·Henrik EkbergUNKNOWN ELITE-Symphony Study

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Citations

Apr 23, 2021·Canadian Journal of Physiology and Pharmacology·Salwa Abdel-Tawab IbrahimHanaa Mohamed Khalaf

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