Abstract
Tacrolimus (TAC) is primarily metabolized by the CYP450 3A4 isoenzyme. Voriconazole, often used to prevent fungal infections after allogeneic HSCT, is metabolized by the CYP450 3A4, 2C9 and 2C19 isosenzymes. Clinical trials in healthy volunteers have shown significant drug interactions between the two requiring TAC dose reduction. Ordinarily, TAC is started at the dose of 0.03 mg/kg IV daily on day -1. After starting it at this dose and having to reduce the dose substantially within 2–3 days in all patients receiving concomitant voriconazole 200 mg twice daily orally from day 0, we implemented a simple, preemptive TAC dose reduction strategy to maintain steady-state levels between 5 and 15 ng/mL.
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