We are reporting on the utilization of phenytoin to assist in decreasing tacrolimus concentrations in a case series of four solid organ transplant recipients with acute, symptomatic tacrolimus toxicity presenting with elevated serum creatinine, potassium, and tacrolimus trough concentrations greater than 30 ng/mL. To evaluate the relationship between tacrolimus whole blood concentrations and . 28) at different tacrolimus whole blood concentration levels (total number of between high concentrations of tacrolimus and toxicity are in agreement with Results - Introduction - Methods. Tacrolimus can cause kidney damage (nephrotoxicity), especially in high doses. Measuring levels in people who have had a kidney transplant may help to distinguish between kidney damage due to rejection (because drug level is low) and kidney damage due to tacrolimus toxicity (drug level is high).
O'Connor AD, Rusyniak DE, Mowry J. Acute tacrolimus toxicity in a non- transplant . Cyclosporine plasma levels in renal transplant patients. The therapeutic levels of whole blood tacrolimus trough concentrations range from 5–20mg/L, but to prevent toxicity the usual range is 5–15mg/L (14,15). In. Target trough levels for modified-release tacrolimus seem to be the same as for to that associated with toxicity) and when there is a high level of variability in.
Unintentional overdose cases were reported with both the oral and the intravenous In each of these eight symptomatic cases, all symptoms and toxicities. Serum drug levels >30 ng/mL are considered toxic and require immediate medical attention,11 Treating an over- dose can be difficult because tacrolimus. Several case reports suggest phenytoin and rifampin decrease tacrolimus levels in toxicity, but does it actually make a difference?.
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