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Achieving target concentrations of tacrolimus is important – if levels are too low, then there is a risk of transplant rejection, if levels are too high, there is a risk of drug toxicities. There is evidence to suggest that dosing patients based on rs776746 genotype can result in faster and more frequent achievement of target tacrolimus levels.
Tacrolimus (trade names Prograf, Astagraf XL, Envarsus XR) is a product of the bacterium Streptomyces tsukubensis. It is a macrolide lactone and acts by inhibiting calcineurin . The drug is used primarily in liver and kidney transplantations, although in some clinics it is used in heart, lung, and heart/lung transplantations.
Most of the other contraindications are avoiding cases where a potential side effect exacerbates a pre-existing condition: for example, because oclacitinib can cause lumps or tumors, it should not be used in dogs with cancer or a history of it; [15] because it is an immune system suppressant, it should not be used in dogs with serious infections.
One study of a dog suffering from a toxic dose found that it was probably 111 milligrams per kilogram, or about 100 times the normal dose (3). Other reports list the lethal dose (LD50) at 24 to 30 ...
If the observed concentration is plausible but far from the suitable level, determine how to adjust the dosage to drive the concentration curve close to target. Several approaches exist for this, from the easiest “rule of three” to sophisticated computer-assisted calculations implementing Bayesian inference algorithms based on population ...
In a medicine that is administered periodically, the trough level should be measured just before the administration of the next dose in order to avoid overdosing. [3] A trough level is contrasted with a "peak level" (C max), which is the highest level of the medicine in the body, and the "average level", which is the mean level over time. It is ...
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