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Updated: May 8, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
Published on: November 8, 2015
The development of a bioanalytical method for the simultaneous analysis of gentamicin and tacrolimus in Rat whole
Shrooq Altaweel1,2, Ann Van Schepdael2, Erwin Adams3
1Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, P.O. Box 22452, 11495, Riyadh, Saudi Arabia.
Abstract:
Tacrolimus (TAC) is commonly administered to patients who have undergone organ transplantation to prevent the immune system from rejecting the transplanted organ. Multidrug-resistant bacterial infections are the most frequent complications during the first-month post-transplantation. Old antimicrobial agents such as gentamicin (GEN) are widely used to treat opportunistic nosocomial infections in immunosuppressed TAC patients. Nephrotoxicity is a significant side effect of GEN and TAC, but some studies indicated their concurrent administration. However, there is no information on whether the combination of the two drugs may result in a more significant impairment of kidney function than either drug used separately. To investigate this, both drugs should be monitored in blood. Sample preparation was carried out using protein precipitation, requiring only 50 µL of WB sample with an extraction recovery of not less than 95.2% (GEN) and 93.2% (TAC). Analytes and internal standard (IS) were monitored using mass spectrometry (MS) in positive ion mode by multiple reaction monitoring (MRM). Chromatographic analysis was performed on an Acquity UPLC BEH C18 column (50 mm × 2.1 mm, 1.7 μm), kept at 50 °C and using gradient elution. Mobile phase A contained 2 mmol/L ammonium formate acidified with 0.1% formic acid in water, and mobile phase B was a mixture of 2 mmol/L ammonium formate and 0.1% formic acid in methanol, pumped at a flow rate of 0.25 mL/min. The analysis time was only 6 min. The method was verified according to the European Medicines Agency (EMA) guidelines over a concentration range of 19.5-2500 ng/mL for GEN and 1.95-250 ng/mL for TAC. Determination coefficients for the calibration curves were found to be ≥ 0.999. Within- and between-run precision and accuracy were evaluated for both drugs with relative standard deviations (RSD) ≤ 6.5% and inaccuracy ≤ 6.6%. The proposed method was successfully applied to analyze the WB samples at different time points after the co-administration of GEN and TAC to Wistar rats. In this work, a new bioanalytical UHPLC-MS/MS method was developed and validated for simultaneous quantification of total GEN congeners (C1, C1a, and C2/C2a) and TAC in Wistar rats whole blood (WB). The protein precipitation method has been chosen to extract the drug from the WB sample. The assay method has been successfully used to estimate the concentration of TAC and GEN after co-administration in rats.
Insights
This study developed a new UHPLC-MS/MS method to simultaneously measure tacrolimus (TAC) and gentamicin (GEN) in rat blood. This method helps assess the safety of co-administering these drugs, crucial for transplant patients.
Area of Science:
- Pharmacology
- Analytical Chemistry
- Toxicology
Background:
- Tacrolimus (TAC) is vital for preventing organ transplant rejection.
- Gentamicin (GEN), an older antibiotic, treats infections in immunosuppressed transplant patients.
- Both TAC and GEN can cause nephrotoxicity, but their combined effects on kidney function remain unclear.
Purpose of the Study:
- To develop and validate a novel bioanalytical method for simultaneous quantification of TAC and GEN in whole blood.
- To enable monitoring of TAC and GEN concentrations following co-administration in a preclinical model.
- To provide a tool for investigating potential synergistic nephrotoxicity of combined TAC and GEN therapy.
Main Methods:
- Developed a rapid ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) assay.
- Utilized protein precipitation for sample preparation from small volumes (50 µL) of whole blood.
- Validated the method according to European Medicines Agency (EMA) guidelines for accuracy, precision, and linearity.
Main Results:
- Achieved high extraction recovery for both GEN (≥95.2%) and TAC (≥93.2%).
- Demonstrated excellent linearity (R² ≥ 0.999) and low variability (RSD ≤ 6.5%) for both analytes.
- Successfully applied the validated method to quantify TAC and GEN in Wistar rats after co-administration.
Conclusions:
- A robust and efficient UHPLC-MS/MS method for simultaneous TAC and GEN determination in whole blood was established.
- The method's speed (6-minute analysis time) and minimal sample requirement make it suitable for routine monitoring.
- This validated assay facilitates further research into the safety and efficacy of combined TAC and GEN therapy in transplantation.
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