Pediatr Transplant. 2000 Feb;4(1):63-6.

Increased tacrolimus levels in a pediatric renal transplant patient attributed to chronic diarrhea.

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Department of Pediatrics, Tulane University School of Medicine and Tulane University Medical Center, New Orleans, Louisiana 70112, USA. seadesrx@aol.com

Abstract

Tacrolimus is an immunosuppressant used to prevent rejection of transplanted organs. It is metabolized in both the gut and the liver by the cytochrome P450 (CYP) 3A4 enzyme system and is a substrate for the P-glycoprotein (P-gp) drug efflux pump. As CYP3A4 enzymes and P-gp are present at differing concentrations throughout the gastrointestinal tract, the bioavailability of tacrolimus may be influenced by changes in gastrointestinal transit time in addition to changes in hepatic metabolism. We report the case of a pediatric renal transplant patient who experienced a three-fold increase in serum tacrolimus concentrations during an episode of gastroenteritis with chronic diarrhea.

PMID:: 10731062; [PubMed - indexed for MEDLINE]

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Increased tacrolimus trough levels in association with severe diarrhea, a case report. [Transplant Proc. 2004]
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Cited by 1 PubMed Central article

Evaluation of limited sampling methods for estimation of tacrolimus exposure in adult kidney transplant recipients. [Br J Clin Pharmacol. 2011]
Evaluation of limited sampling methods for estimation of tacrolimus exposure in adult kidney transplant recipients.
Barraclough KA, Isbel NM, Kirkpatrick CM, Lee KJ, Taylor PJ, Johnson DW, Campbell SB, Leary DR, Staatz CE. Br J Clin Pharmacol. 2011 Feb; 71(2):207-23.

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