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    In vitro the following substances have been shown to be potential inhibitors of tacrolimus metabolism: bromocriptine, cortisone, dapsone, ergotamine, gestodene, lidocaine, mephenytoin, miconazole, midazolam, nilvadipine, norethisterone, quinidine, tamoxifen, troleandomycin.

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    The tacrolimus-FKBP complex inhibits the calcium-dependent phosphatase, calcineurin, which cpt codes for tacrolimus to the inhibition of T-cell activation, resulting in immunosuppression. 4 Clinical IndicationsTACR, which is cpt code for tacrolimus to cyclosporine, but 100 times more potent, is mainly indicated for the following: Prevention of transplant rejectionAs a substitute to cyclosporine for primary immunosuppression following solid organ transplantation2 As a rescue therapy in patients with refractory rejection with cyclosporine treatmentProphylaxis against host-versus-graft diseaseTopical therapy for atopic dermatitis, scleroderma, and other eczematous diseases6 Suppressing inflammation in inflammatory bowel disease, severe steroid-refractory or steroid-dependent ulcerative colitis, and Crohn s disease.BKVN usually results from excessive immunosuppression therapy2, 3 and predisposes to graft dysfunction or graft loss4, 5.

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    Conclusions: These results suggest that liver transplant patients currently taking the reference tacrolimus formulation may be safely switched to the Sandoz-generic product Adoport provided through concentrations are closely monitored following the substitution.

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