Effects of converting tacrolimus formulation from twice-daily to once-daily in liver transplantation recipients

Biomed Res Int. 2014:2014:265658. doi: 10.1155/2014/265658. Epub 2014 Jul 14.

Abstract

Typically, tacrolimus is administrated twice daily. Prolonged-release tacrolimus is the once-daily formulation and may be more convenient for patients. Experience with the administration of the once-daily formulation is still limited. This study enrolled 210 liver transplant recipients who had stable liver function and converted tacrolimus from a twice-daily to once-daily formulation on a 1 mg to 1 mg basis. Among 210 patients, seven patients (3.3%) were withdrawn from the once-daily formulation due to allergy and fatigue. For the other patients, the trough concentration after converting to the once-daily formulation was lower than that of the twice-daily formulation. Liver enzymes were mildly elevated in 3 months after formulation conversion and serum creatinine and uric acid were mildly decreased. Seven patients (3.4%) had clinical suspicion of acute rejection after the formulation conversion and three of them were caused by nonadherence. 155 patients (76.4%) experienced a more convenient life with an increase of social activity. Forty-seven patients (23.2%) experienced the convenience of once-daily formulation during overseas trips. In conclusion, tacrolimus can be safely converted from the twice-daily to the once-daily formulation for most stable liver recipients. Acute rejection may occur in a minority of patients during formulation conversion and should be carefully monitored.

Publication types

  • Clinical Trial

MeSH terms

  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Chemistry, Pharmaceutical
  • Creatinine / blood
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Humans
  • Kidney Function Tests
  • Liver Function Tests
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Tacrolimus / administration & dosage*
  • Tacrolimus / adverse effects
  • Tacrolimus / blood
  • Tacrolimus / therapeutic use*
  • Uric Acid / blood

Substances

  • Uric Acid
  • Creatinine
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Tacrolimus