Transplantation Reports · Published 2025-02-24 · DOI 10.1016/j.tpr.2025.100175
Maintaining optimal tacrolimus serum concentrations is crucial for kidney transplant recipients due to its narrow therapeutic window and pharmacokinetic variability. The use of CYP3A4/5 inhibitors, such as fluconazole and verapamil, can increase tacrolimus serum concentrations. Understanding these interactions is vital for predicting and optimizing tacrolimus levels. This study aimed to investigate the impact of co-administering fluconazole, verapamil, or their combination on tacrolimus concentration/dose (C/D) in kidney transplant recipients and develop a predictive model for these scenarios. This retrospective study involved kidney transplant recipients treated with tacrolimus and co-administered fluconazole and/or verapamil. The Generalized Estimating Equations (GEE) approach was used to explore predictive variables associated with tacrolimus C/D. A total of 177 kidney transplant recipients were included. Repeated measure correlation analysis revealed positive correlations between tacrolimus C/D and dosages of fluconazole (b = 0.37, 95 % CI = 0.29 to 0.45, p < 0.001) and verapamil (b = 0.15, 95 % CI = 0.07 to 0.23, p < 0.001). This study offers a predictive model for optimizing tacrolimus levels when fluconazole and/or verapamil are co-administered in kidney transplant recipients.
Abstract from DOAJ. Public domain (CC0 1.0).
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