Q: Which one precaution at the bedside may help to avoid falsely elevated level of Tacrolimus?
Answer: Tacrolimus has a potential to leach into the plastic catheters. If blood is drawn to measure the tacrolimus level from the same port which is used to administer tacrolimus, the levels are likely to be falsely high.
Another clinical point to remember is that following oral administration, tacrolimus absorption can be erratic and incomplete. It is advisable to start oral tacrolimus when a patient is back to normal oral intake.
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References:
1. Jusko WJ, Piekoszewski W, Klintmalm GB, et al. Pharmacokinetics of tacrolimus in liver transplant patients. Clin Pharmacol Ther 1995; 57:281.
2. Mekki Q, Lee C, Aweeka F, et al. Pharmacokinetics of tacrolimus (FK506) in kidney transplant patients. Clin Pharmacol Ther 1993; 53:238.
3. Friciu M, Zaraa S, Leclair G. Stability of Extemporaneously Compounded Tacrolimus in Glass Bottles and Plastic Syringes. Can J Hosp Pharm. 2017;70(1):51-53. doi:10.4212/cjhp.v70i1.1629
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