Haroon Nivin, Singh Atul, Bhat Zeenat Yousuf
Division of Nephrology, Department of Internal Medicine, Wayne State University, Detroit, MI.
Am J Ther. 2016 Mar-Apr;23(2):e631-4. doi: 10.1097/MJT.0000000000000219.
Tacrolimus (FK 506 or Fujimycin) is an effective anti-T-cell agent derived from the fungus Streptomyces tsukubaensis. Some in vitro studies have demonstrated that the potency of tacrolimus can be up to 100 times to that of cyclosporine. Despite being a very potent immunosuppressant, its use is complicated by narrow therapeutic range, individual variation in pharmacokinetics, and a broad spectrum of drug interactions. We report a case of very high tacrolimus level (>120 ng/mL) in a patient who was on antiretroviral medication and tacrolimus. Despite having such high drug levels, patient's clinical presentation and course was benign. He was managed conservatively and this ordeal resulting in no long-term sequela.
他克莫司（FK 506或普乐可复）是一种从筑波链霉菌中提取的有效的抗T细胞药物。一些体外研究表明，他克莫司的效力可比环孢素高100倍。尽管它是一种非常强效的免疫抑制剂，但其使用因治疗窗窄、药代动力学个体差异以及广泛的药物相互作用而变得复杂。我们报告了一例正在接受抗逆转录病毒药物治疗并服用他克莫司的患者，其他克莫司水平非常高（>120 ng/mL）。尽管药物水平如此之高，但患者的临床表现和病程却是良性的。他接受了保守治疗，这场磨难并未导致长期后遗症。
