Related Experiment Video

Updated: Aug 21, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Diltiazem use in tacrolimus-treated renal transplant recipients

J Kothari1, M Nash, J Zaltzman

  • 1St Michael's Hospital, University of Toronto, Ontario, Canada.

Journal of Clinical Pharmacy and Therapeutics
|October 16, 2004
PubMed

Insights

Diltiazem is safe and effective for managing post-kidney transplant hypertension in patients on tacrolimus. This calcium channel blocker can be a first-line treatment option without impacting tacrolimus levels or costs.

Area of Science:

  • Nephrology
  • Pharmacology
  • Transplant Medicine

Background:

  • Calcium channel blockers are used for post-transplant hypertension but may interact with calcineurin inhibitors.
  • Limited data exist on diltiazem use with tacrolimus (immunosuppressant) in renal transplant recipients.

Purpose of the Study:

  • To evaluate the safety and efficacy of diltiazem in renal transplant patients receiving tacrolimus-based immunosuppression.
  • To assess the impact of diltiazem on renal function, blood pressure control, and tacrolimus exposure.

Main Methods:

  • Retrospective analysis of renal transplant recipients from March 1997 to March 2002.
  • Patients received tacrolimus, mycophenolate mofetil, and prednisone.
  • Comparison of outcomes between patients who received diltiazem in the first postoperative week and a control group.

Main Results:

  • No significant differences in renal function, graft survival, or patient survival at 2 years between groups.
  • Similar blood pressure control, though the diltiazem group required more antihypertensive medications.
  • No increased tacrolimus-related side effects or altered tacrolimus exposure/monitoring costs.

Conclusions:

  • Diltiazem is safe and effective as a first-line antihypertensive in renal transplant recipients on tacrolimus.
  • Diltiazem use is cost-neutral concerning tacrolimus monitoring and overall costs.
Abstract

Related Concept Videos

Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...