Trial reportBone marrow transplantation2010
Tacrolimus use in adult allogeneic stem cell transplant recipients receiving voriconazole: preemptive dose modification and therapeutic drug monitoring.
Trial report in Bone marrow transplantation, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 45 citations in OpenAlex.
- A Randomized Trial of Caspofungin vs Triazoles Prophylaxis for Invasive Fungal Disease in Pediatric Allogeneic Hematopoietic Cell Transplant.Journal of the Pediatric Infectious Diseases Society · 2021Trial
- Impact of cytochrome P450 2C19 polymorphisms on the pharmacokinetics of tacrolimus when coadministered with voriconazole.Journal of clinical pharmacology · 2016Trial
- Endocrine-related neurological function recovery in pancreatic transplantation.World journal of transplantation · 2025Article
- [S1 guideline: diagnosis and treatment of invasive pulmonary aspergillosis in critically ill/intensive care patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Recommendations on the use of azole antifungals in hematology-oncology patients.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Review
- Therapeutic drug monitoring andTranslational pediatrics · 2022Article
- Real clinical impact of drug-drug interactions of immunosuppressants in transplant patients.Pharmacology research & perspectives · 2021Observational
- [The effect of CYP3A5 gene polymorphism on tacrolimus concentration and adverse events in patients undergoing allogeneic hematopoietic stem cell transplantation].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2021Article
- TargetedThe Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2019Article
- High on Cannabis and Calcineurin Inhibitors: A Word of Warning in an Era of Legalized Marijuana.Case reports in transplantation · 2016Article
- Dosing algorithm for concomitant administration of sirolimus, tacrolimus, and an azole after allogeneic hematopoietic stem cell transplantation.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2015Article
- Safety of voriconazole and sirolimus coadministration after allogeneic hematopoietic SCT.Bone marrow transplantation · 2015Article
- A case of treatment with voriconazole for chronic progressive pulmonary aspergillosis in a patient receiving tacrolimus for dermatomyositis-associated interstitial lung disease.Respiratory medicine case reports · 2015Article
- A prospective feasibility study of primary prophylaxis against invasive fungal disease with voriconazole following umbilical cord blood transplantation with fludarabine-based conditioning.International journal of hematology · 2014Article
- Practice guidelines for therapeutic drug monitoring of voriconazole: a consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2013Article
- Antifungal prophylaxis in pediatric hematology/oncology: new choices & new data.Pediatric blood & cancer · 2012Review
- Drug interaction between voriconazole and tacrolimus in allogeneic hematopoietic SCT recipients.Bone marrow transplantation · 2011Article
- Phenytoin and Rifampin Do Not Decrease Levels in Acute Tacrolimus Toxicity.Journal of investigative medicine high impact case reportsArticle
- Evaluation of the Interaction of Intravenous and Oral Voriconazole with Oral Cyclosporine in Iranian HSCT Patients.Journal of research in pharmacy practiceArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Concomitant use of tacrolimus and voriconazole, both competitive inhibitors of the CYP450 3A4 isoenzyme, requires tacrolimus dose reduction. On the basis of clinical observations, we developed a preemptive dose-reduction strategy in allograft recipients who received voriconazole to maintain tacrolimus concentrations within a target range. A total of 27 patients started i.v. tacrolimus at an average daily dose of 0.022 mg/kg on day -1 (30% lesser than the usual starting dose). The dose was reduced by 30-40% if the 48-h steady-state concentration was 7-10 ng/ml, and by 40-50% if it was 10-15 ng/ml. No change was made if the concentration was <7 ng/ml. Subsequently, concentrations were generally monitored 2-3 times a week with dose adjustments as necessary. None of the 170 levels (3-12 per patient; median 5) obtained between days +1 and +16 were subtherapeutic (<5 ng/ml) and only 34 levels (20%) were >15 ng/ml. Each patient required dose reduction at least twice. The dose had to be increased in only two patients after the initial dose reduction. The median tacrolimus doses in mg/kg declined with time; being 0.022, 0.008 and 0.006 on days 0, 7 and 14, respectively. We conclude that a preemptive dose-reduction strategy is effective in maintaining tacrolimus concentrations within the desired therapeutic range, although serial monitoring remains prudent.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.