Switch from once-daily tacrolimus (Advagraf) to twice -daily prolonged | HABIBA FETATI
Summary :
Tacroclimus is an immunosuppressive drug widely used for the prevention of rejection in organ transplants. It is marketed in two forms: Prograf administered twice a day and Advagraf which allows only one administration per day. Advagraf is often used in liver transplantation. Through this clinical case, we demonstrate the role of the therapeutic drug monitoring in dosage optimization during the switch tacrolimus from the Advagraf form to the Prograf form. This is a 60-year-old patient who underwent liver transplantation in 2014 treated with Advagraf 2.5 mg once in the morning. The residual CO concentration was 7 ng / ml. Due to the unavailability of advagraf, this drug was switched to the prograf form on 06/15/2020 at the same dosage 2.5 mg / d in two doses (1.5 mg in the morning and 1 mg in the evening ). Co increased from 7 to 11 ng / ml, AUC was 194 ng.h / ml [120-150]. When substitution of Advagraf with Prograf, C0 monitoring should be regular and close and dosage adjustments should be made to ensure that a similar systemic exposure is maintained.
About Author :
Habiba Fetati PharmD and Master assistant in Pharmacology at the Pharmacovigilance department of the Hospital and University Establishment of Oran and a member of the Pharmaceutical Development Research Laboratory (LRDP), Oran1 university Ahmed Ben Bella, Oran, Algeria.
