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Updated: May 25, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
The once-daily formulation of tacrolimus: a step forward in kidney transplantation?
Jean-Michel Hougardy1, Hylke de Jonge, Dirk Kuypers
1Department of Nephrology, Clinique Universitaire Hôpital Erasme, Renal Transplantation Clinic, Brussels, Belgium. jehougar@ulb.ac.be
Abstract:
Nonadherence is a critical issue in transplantation. Recently, Astellas designed a once-daily-extended release formulation of tacrolimus (Tac). Despite initial reports showing bioequivalence of Tac once-daily (Advagraf) with the original formulation requiring twice-daily intake (Tac twice-daily, Prograf), several groups have now shown a sustained decrease in Tac exposure upon conversion from Prograf to Advagraf. Here, we discuss the possible reasons for this observation and how it could affect the expected benefits of Advagraf, and we comment on the fact that a similar lack of bioequivalence might prevail with generic immunosuppressive drugs.
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