他克莫司胶囊的用法用量

Tacrolimus capsule is an important immunosuppressant, mainly used to prevent organ rejection after kidney transplantation. Correct mastery of its usage and dosage is crucial to the therapeutic effect. At the same time, attention should be paid to possible side effects and medication precautions for special groups. This article will introduce in detail the usage and dosage, side effects and medication for special groups to help patients and medical staff use the drug scientifically and rationally.

Usage and dosage of tacrolimus capsules

The usage and dosage of tacrolimus capsules must strictly follow the doctor’s instructions to reduce the occurrence of adverse reactions. The following content details medication guidance, recommended dosage regimens, and dosage adjustment principles.

Important Medication Instructions

Tacrolimus capsules should be taken on an empty stomach every morning. The best time is 1 hour before a meal or 2 hours after a meal. Swallow capsules whole, avoiding chewing, crushing or splitting capsules. If you miss a dose, you can take it within 14 hours. If it exceeds 14 hours, you can skip it and take it at the original time the next day. Do not double the dose. Grapefruit, grapefruit juice and alcohol need to be avoided in the diet to avoid affecting drug absorption or increasing the risk of toxicity.

Recommended dosage regimen

When combined with basiliximab for induction therapy in adult patients, the initial dose is 0.15-0.20 mg/kg, once a day, starting before reperfusion or within 48 hours after transplantation. The target blood drug concentration is 7-15ng/mL in the first month, 5-15ng/mL in the 2nd-6th month, and 5-10ng/mL after 6 months.

For adult patients who have not used basiliximab induction therapy, the first dose before surgery is 0.1 mg/kg, and the maintenance dose after surgery is 0.2 mg/kg once a day. The initial dose for pediatric patients (≥4 years) is 0.3 mg/kg once daily, with a target plasma trough concentration of 10-20 ng/mL in the first month and 5-15 ng/mL after 1 month.

Dose Adjustment and Monitoring

African Americans may require higher doses to achieve target plasma concentrations. Patients with severe hepatic impairment (Child-Pugh ≥ 10) need to reduce the starting dose. Monitor whole blood trough concentrations at least twice weekly after initial administration or dose adjustment. When using strong CYP3A inhibitors or inducers, frequent concentration monitoring and dose adjustments are required.

Side effects of tacrolimus capsules

Tacrolimus capsules may cause a variety of side effects during treatment. It is important for patients to understand the manifestations and countermeasures of these side effects.

Common adverse reactions

Diarrhea, constipation, nausea, peripheral edema, tremor and anemia are common adverse reactions of tacrolimus capsules. These symptoms usually appear in the early stages of medication, and some patients will gradually adapt as the treatment time is extended. Anemia may be related to drug inhibition of the hematopoietic system.

Serious adverse reactions

Tacrolimus capsules may increase the risk of infections, including bacteria, viruses (such as cytomegalovirus, BK virus), fungi and opportunistic infections. Long-term use may cause malignant tumors such as lymphoma and skin cancer. Metabolic abnormalities (such as new post-transplantation diabetes, hyperkalemia) and organ toxicity (such as nephrotoxicity, neurotoxicity) also require great attention.

Countermeasures

For gastrointestinal discomfort, the diet structure can be adjusted and eating in small amounts in portions. Infection prevention and control requires avoiding contact with infectious sources and regular screening for skin lesions. Patients with metabolic abnormalities need to closely monitor blood sugar and potassium levels, and use symptomatic drugs if necessary.

Understanding the manifestations and countermeasures of side effects can help patients better manage their own health during treatment.

Tacrolimus capsules should be used by special groups

Different groups of people have different metabolism and tolerance of tacrolimus capsules, so special groups need to be extra cautious when using them.

Pregnant and lactating women

Tacrolimus capsules used by pregnant women may cause fetal malformations, and strict contraception is required during treatment. Breastfeeding women should weigh the necessity of breastfeeding or choose alternative feeding because the drug can be secreted into breast milk.

Children and elderly patients

Children aged ≥4 years old need to adjust the dose according to their body weight. Elderly patients need to start the dose carefully because their liver and kidney functions may be reduced. Medication regimens for pediatric and geriatric patients should be based on individualized assessment.

Patients with hepatic and renal impairment

Patients with severe hepatic impairment (Child-Pugh ≥ 10) need to reduce the starting dose and monitor closely. Patients with renal impairment do not need to adjust the dose, but renal toxicity and plasma concentrations need to be monitored.

Medications for special groups need to be formulated based on individual conditions and should be used strictly under the guidance of a doctor.