This article reviews the role of, and factors pertinent to, TDM of the newer immunosuppressive agents tacrolimus (FK-506), sirolimus (rapamycin) and mycophenolate mofetil (MMF) [see Differential ...

In animal models, tacrolimus has less of an inhibitory effect on proliferation of smooth muscle and endothelial cells than sirolimus, but also causes less depression of function of both cell types.

to undergo conversion from immunosuppression with ciclosporin or tacrolimus to one with sirolimus, or to continue receiving CNI-based therapy for 104 weeks (subsequently extended to 208).

Diltiazem and fluconazole are likely to increase tacrolimus concentrations. Ketoconazole has increased plasma sirolimus concentrations by 990%. Diltiazem has increased plasma sirolimus ...