Tacrolimus Toxicities in clinical practice- A Case based perspective

Tacrolimus is a calcineurin inhibitor used as an immunosuppressant and is used in various conditions like prevention of organ transplant rejection, atopic dermatitis and psoriasis. In our set of series we are mainly focusing on toxicities like AKI (acute kidney injury), thrombotic microangiopathy, acute pancreatitis, hypomagnesemia and PRES(Posterior reversible encephalopathy) and hyperkalemia which are some of the major reactions and needs quick intervention. Even though most of the reactions are preventable they should be timely detected and stopped if not may also be fatal. Even though tacrolimus is crucial and cannot be avoided it would be better if given in reduced doses and also avoid longer duration of treatment. Hence monitoring of tacrolimus induced adverse drug reactions may help in getting a picture on avoiding it and help increase patient efficacy and adherence during treatment.