The recommended whole blood concentration of tacrolimus is around 7 mcg/L at steady state with as 12 h dosing interval. When this is standardized to a hematocrit of 45% it is equivalent to around 10 mcg/L. Target concentration attainment is improved using Bayesian forecasting and hematocrit based interpretation of whole blood concentrations(Storset, Holford et al. 2014).
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Sikma, M. A., E. M. Van Maarseveen, C. C. Hunault, J. M. Moreno, E. A. Van de Graaf, J. H. Kirkels, M. C. Verhaar, J. C. Grutters, J. Kesecioglu, D. W. De Lange and A. D. R. Huitema (2020). "Unbound Plasma, Total Plasma, and Whole-Blood Tacrolimus Pharmacokinetics Early After Thoracic Organ Transplantation." Clinical Pharmacokinetics 59(6): 771-780.
Staatz, C. E., E. Størset, T. K. Bergmann, S. Hennig and N. Holford (2015). "Tacrolimus pharmacokinetics after kidney transplantation – Influence of changes in haematocrit and steroid dose." British Journal of Clinical Pharmacology: DOI: 10.1111/bcp.12729.
Storset, E., N. Holford, S. Hennig, T. K. Bergmann, S. Bergan, S. Bremer, A. Asberg, K. Midtvedt and C. E. Staatz (2014). "Improved prediction of tacrolimus concentrations early after kidney transplantation using theory-based pharmacokinetic modelling." Br J Clin Pharmacol 78(3): 509-523.
Storset, E., N. Holford, K. Midtvedt, S. Bremer, S. Bergan and A. Asberg (2014). "Importance of hematocrit for a tacrolimus target concentration strategy." Eur J Clin Pharmacol 70(1): 65-77.