P-85 USE OF LOW DOSES OF GENERIC TACROLIMUS AND THERAPEUTIC LEVELS IN LIVER TRANSPLANT PATIENTS: RESULTS FROM A SINGLE CENTER IN PERU

Introduction

Tacrolimus is the basis of immunosuppressive treatment in liver transplantation, with dosages of blood levels to ensure adequate graft function. In Peru, since 2005 generic tacrolimus has been used exclusively in all transplant centers due to lower costs. There are no presentations (0.5 mg), necessary for its use in a group of transplanted patients who require low doses of the drug.

Objectives

To show the results of the use of low doses (<2 mg/day) of generic tacrolimus, using 0.5 mg capsules and measure tacrolimus blood levels in correlation to the time of transplantation and the frequency of liver graft rejection, toxicity, or infections in this group of patients.

Methods

Observational, descriptive, cross-sectional, and retrospective study. Demographic data, transplant time, dose and blood levels of tacrolimus, rejection, and adverse effects were obtained from electronic medical records from October to December 2020. Inclusion criteria: adults, doses: <2 mg/day, > 3 months use of generic tacrolimus (NORGRAF: The Madras Pharmaceuticals, India) using 0.5 mg capsules, prepared by the Pharmacy Service at the Guillermo Almenara Hospital. Exclusion criteria: Pediatrics, retransplant, combined transplant. Statistical analysis and processing was using SPSS 23.

Results

Eleven of 246 patients (4.52%) were identified. All patients had blood levels within the therapeutic range in relation to transplantation time and graft function. Average daily dose: 1.3 mg (0.5-1.5 mg /d). Average blood levels: 5.82 ng/L (3.57-10.3 ng / ml). Average transplant time: 73 months (3-120 months). There were no rejection episodes or adverse effects of nephrotoxicity, neurotoxicity, or infections.

Conclusion

The use of low doses of generic tacrolimus (<2 mg/d), using 0.5 mg capsules prepared by the Pharmacy service, allows for the proper adjustment of the daily dose of immunosuppression, obtaining therapeutic success in the prevention of cellular graft rejection, especially in long-standing liver transplant patients without presenting toxicity.