Tacrolimus Monitoring and Neurotoxicity Prevention

Therapeutic Levels and Combination Therapy

• The American Association for the Study of Liver Diseases recommends maintaining tacrolimus trough levels between 6-10 ng/ml during the first month after transplantation, followed by 4-8 ng/ml thereafter, and combining tacrolimus with other immunosuppressive drugs (MMF, AZA, or mTOR inhibitors) to allow for a lower range of trough levels 1

Dosage Adjustment and Neurotoxicity Risk

• The risk of neurotoxicity may increase when tacrolimus is administered concomitantly with strong CYP3A inhibitors, and dosage adjustment is recommended in such cases, although the exact adjustment is not specified 1