Therapy with tacrolimus should be administered cautiously in patients with elevated serum potassium levels. Temporary insulin therapy has been required in some patients, while long-term insulin use has been necessary in others. After excluding medication-, viral- and malignancy-related neutropenia, we switched tacrolimus to cyclosporine, which led to resolution of neutropenia.
Cases of PML have been reported in patients treated with tacrolimus. No induction therapy was provided. However, this hypothesis was rejected by The production of cytokines by lymphocytes or monocytes inhibiting hematopoiesis and inducing apoptosis may be another mechanism responsible for tacrolimus-induced neutropenia. Tacrolimus has become an important cornerstone in the prevention of rejection after kidney transplantation. Close monitoring of blood pressure is recommended.Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Applies to: Diabetes MellitusTacrolimus can induce post-transplant insulin-dependent diabetes mellitus (PTDM). Pharmacokinetic analyses comparing generic tacrolimus preparations versus the reference drug in kidney transplant patients are lacking. Ideally diagnosis should be made by a single test showing a clear relation between myelosuppresion and a specific agent. They both interfere with transcription of early T cell activation genes, which may also be important in nonlymphoid hematopoiesis (Analogous to other medication, it has been proposed that tacrolimus could induce a maturation stop in myeloid precursor cells. Unfortunately in practice no such test exists in the case of medication-induced neutropenia, making the diagnosis mostly tentative by excluding other potential causes and by discontinuing the suspected medication, which led to regression or improvement of neutropenia.Although structurally unrelated to cyclosporine, tacrolimus' mechanism of action is similar, with inhibition of calcineurin and subsequent of IL-2 production being the common pathway. PTDM has occurred in a greater percentage of tacrolimus-treated (20%) versus cyclosporine-treated (4%) kidney transplant patients. Definitive proof of this hypothesis was obtained by discontinuation of tacrolimus and switching to cyclosporine, which led to recovery of white blood cell count in all three patients.Tacrolimus is part of current immunosuppressive protocols after kidney transplantation. Polyoma virus infections in transplant patients may have serious, and sometimes fatal, outcomes. However, a recent case report described an~two-fold increase in tacrolimus levels observed in a 58 year-old kidney transplant recipient who ingested green tea while receiving tacrolimus …
Seventy-six days after transplantation he developed leucopenia (1600/μl) with neutropenia (1200/μl). After having excluded viral infections and bone marrow pathology by blood and marrow investigation, medications known to cause leucopenia were immediately stopped or tapered (Neutropenia-related characteristics of the three patientsCytopenias including neutropenia are frequently observed and potentially life-threatening complications in renal transplant recipients.The incidence of leucopenia and neutropenia in kidney transplant recipients ranges from 10% to 55.5% and from 4.9% to 37.5%, respectively (Medication-induced myelosuppression can be caused by numerous agents, including immunosuppressive and anti-infectious drugs. However, our examples make the contribution of tacrolimus very likely because not only were other causes were excluded but, most importantly, neutropenia completely resolved after conversion from tacrolimus to cyclosporine. Although no such antibodies have been described with tacrolimus, this does not exclude this hypothesis because, for example, in more than half of the patients with immune thrombocytopenia no autoantibody can be demonstrated (It is clear that currently the precise mechanism of tacrolimus-induced neutropenia remains uncertain.
However, its use has been complicated by several side effects, including chronic allograft nephropathy, diabetes mellitus, arterial hypertension, and neurotoxicity. Test Name: TACROLIMUS (FK506) LEVEL (FAIRVIEW UM ... Kidney Transplant Range (ug/L) Pediatric 0 – 3 months post transplant 10 - 12 3 – 6 months post transplant 8 – 10 6 – 12 months post transplant 6 – 8 >12 months post transplant 4 – 7 Adult
Close monitoring of potassium levels is recommended.