What are target tacrolimus troughs for kidney transplant?

Kidney transplant: month 0-3 trough 8-12 ng/mL; month 3-12 trough 6-10 ng/mL; >12 months trough 4-8 ng/mL; targets are lower in low-immunological risk recipients and in combination with mTOR inhibitors.

What is cyclosporine C2 monitoring?

C2 (2-hour post-dose) level better reflects area under the curve than trough (C0); C2 targets for kidney transplant: early post-transplant 1200-1500 ng/mL, maintenance 600-1000 ng/mL.

What drug interactions increase calcineurin inhibitor levels?

Strong CYP3A4/P-gp inhibitors markedly increase levels: azole antifungals (400-600% increase), diltiazem, verapamil, macrolide antibiotics; inducers (rifampin, phenytoin, carbamazepine) dramatically decrease levels.

How does nephrotoxicity from calcineurin inhibitors present?

Acute: dose-dependent vasoconstriction of afferent arteriole causing reversible AKI (creatinine rise); chronic: irreversible interstitial fibrosis/tubular atrophy; hypertension and hyperkalemia are associated effects.

What is the significance of intra-patient variability in tacrolimus levels?

High intra-patient variability (coefficient of variation >40%) in tacrolimus troughs is an independent risk factor for rejection and chronic allograft injury; stable consistent levels predict better graft outcomes.

Calcineurin Inhibitor (Cyclosporine/Tacrolimus) TDM Calculator

Monitors cyclosporine C0 and C2 levels and tacrolimus trough levels in solid organ transplantation, calculates dose adjustments based on target troughs by time post-transplant and organ type.

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Frequently Asked Questions

What are target tacrolimus troughs for kidney transplant?

What is cyclosporine C2 monitoring?

What drug interactions increase calcineurin inhibitor levels?

How does nephrotoxicity from calcineurin inhibitors present?

What is the significance of intra-patient variability in tacrolimus levels?