Tacrolimus has a strong immunosuppressive effect. In addition, tacrolimus can also promote the affinity of glucocorticoid receptors, inhibit the "drug pump" P glycoprotein, and improve the drug resistance of patients. So, how should tacrolimus be used correctly?
1.Take on an empty stomach
Tacrolimus is primarily administered orally. It can be absorbed in the whole digestive tract. The rate and extent of absorption are greatest on an empty stomach. Food can affect the rate and extent of tacrolimus absorption, especially a high-fat diet.
2. Take the medicine at a fixed time every day
Accurate administration time is the key to ensure the authenticity of tacrolimus blood concentration. It is recommended that the time of taking the medicine be as fixed as possible every day. Tacrolimus capsules are taken twice daily with a 12-hour interval (eg, 8:00 am and 8:00 pm).
3. Regular monitoring of blood drug concentration
In the initial use, clinicians will evaluate the indications and risks, start with a small dose according to factors such as age, weight, renal function, etc. and monitor the blood drug concentration to ensure that it reaches the therapeutic concentration and minimize the risk of drug overdose. risk.
4. Follow the correct blood collection times
For oral administration, the blood collection time should be about 12 hours after administration, that is, before the next administration (trough concentration). Blood collection time should be at least 4-5 days after taking the medicine continuously.
5. Do not change the monitoring site and manufacturer frequently
Different instruments for monitoring the blood concentration of tacrolimus may result in inconsistent results. It is recommended that patients try to fix the blood concentration in a hospital as much as possible. If the manufacturer must be changed, the trough plasma concentration needs to be monitored until the target concentration is maintained stable.
6. Be aware of drug interactions
The main metabolizing enzyme of tacrolimus is P450-3A4. Any drug that affects the P450 3A enzyme system of the liver may affect the drug concentration of tacrolimus. Tacrolimus is known to interact with more than 150 drugs.
7. Watch out for foods to avoid
Strictly avoid eating grapefruit while taking tacrolimus, including various beverages that contain grapefruit juice. In addition, various teas, beverages containing tea, and other common foods will also affect the concentration of tacrolimus and should be avoided as much as possible.
8. Beware of adverse drug reactions
Tacrolimus is mainly metabolized in the liver and intestine, and abnormal liver function can affect the metabolism of tacrolimus. Therefore, patients with abnormal liver enzymes need to reduce the dosage of tacrolimus to avoid excessive tacrolimus blood concentration and increase adverse reactions.
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