There was no significant difference between the treatment groups on week 0, however highly significant difference was observed on 2nd week and 4th week between group A (Tacrolimus
) and group B (Placebo) (Table 1) (Fig 1b, 2b, 3b).
Alloway et al., in a prospective, multicenter, open-label, randomized crossover study undertaken with the objective of comparing the steady-state pharmacokinetics of a generic tacrolimus
(Sandoz) versus the originator drug (Prograf) in stable kidney transplant patients, observed a similar pharmacokinetic profile for both products according to US FDA and European Medicines Agency guidelines (EMA) .
Pharmacogenetics, which is the study of genetic differences affecting individual responses to drugs, might help to optimize the initiation and maintenance dosage of tacrolimus
to reach its target concentrations rapidly and to reduce its adverse reactions [7, 8].
In most reports, tacrolimus
hepatotoxicity has been characterized by elevated levels of hepatocellular enzymes, either alone or with minimal cholestasis and hyperbilirubinemia.
A recent report by Zarrinpar and colleagues (1) used a "parabolic personalized dosing" (PPD) platform to manage dosing changes of tacrolimus
in liver transplant patients.
Seven of the 22 (31.8%) episodes of NCs were tremor Six of the seven patients with tremor were using tacrolimus
, and one patient was using cyclosporine.
Frequencies of minoxidil and tacrolimus
use were nearly identical even though tacrolimus
has been found ineffective in alopecia areata, according to the researchers.
has similar immunosuppressive properties to cyclosporine, but is much more potent in its inhibitory effect (2).
Subsequent treatment consisted of 80 mg/day mPSL and 2 mg/day tacrolimus
. Four days after the first mPSL pulse therapy, fever was slightly improved, but WBC and CRP had increased to 24,010/[mm.sup.3] and 15.31 mg/dL, respectively.
A previous clinical trial by other investigators showed that twice-weekly maintenance therapy with topical tacrolimus
kept adult atopic dermatitis in remission for extended periods and reduced the incidence of eczema exacerbations (Allergy 2008;63:742-50).
So, we considered alternate therapy solely with topical tacrolimus
0.1% twice daily application.
, made from fungus Streptomyces tsukubanesis, is a calcineurin inhibitor and has anti-inflammatory effects.8,9 Hand eczema has been effectively treated with tacrolimus
.8,9 Inflammatory skin diseases like eczema are also effectively treated with topical steroid mometasone furotate.9