Acceptable ranges of trough (12 hour) tacrolimus levels may be wide, and general principles dictate that levels should be higher early on, and in those with high immunological risk. However, many factors such as drug adverse effects, dose of MMF, tolerated, infectious risk, and prior clinical events also influence the target range.
Lower target levels are usually sought in the first month in patients at high risk of delayed graft function, eg. 5-7 (for standard risk).
|Standard Risk||High Risk|
|Month 1||7 – 10|
|Month 2 – 3||6 – 9|
|Month >3||4 – 8|
Lower risk patients will usually be set target levels towards the lower end of the range, and higher risk towards the upper end.