Figure 134

Relationship between blood levels of tacrolimus, immunosuppressive efficacy, and toxicity [7]. As tacrolimus levels diminish, particularly during the early period after transplantation, the risk of toxicity is reduced accordingly. However, the risk of acute rejection increases. Toxicity still can occur at very low drug levels, as can rejection at high levels. The relationship between these variables beyond the first 6 to 12 months after transplantation is not well established. A similar plot could be constructed for cyclosporine. (Adapted from Kershner and Fitzsimmons [7].)

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