tacrolimus and Flushing

In this article there were regarded the most frequent side effects that appear in the patients who have been treated with topical tacrolimus, and the association between topical tacrolimus and the development of tumors is unfolded. The irritation in the site of application of the tacrolimus can manifiest as pruritus, sensation of burning and/or eritema located to the area of the application. It is the most frequent side effect, independently of the duration of the study. The cutaneous infections, especially the viral ones, tend to be more numerous in patients with atopic dermatitis that receive topic tacrolimus. After reviewing the medical literature one concludes that nowadays there doesn t exist scientific evidence of an increase of skin cancer, lymphomas or systemic immunosuppression in those patients that use or have used topical tacrolimus. Nevertheless, it is not possible to exclude the possibility that there appear cutaneous and/or systemic long-term side effects.

Topics: Administration, Cutaneous; Animals; Calcineurin Inhibitors; Clinical Trials as Topic; Dermatitis, Atopic; Flushing; Humans; Immunosuppressive Agents; Neoplasms; Neoplasms, Experimental; Organ Transplantation; Postoperative Complications; Pruritus; Retrospective Studies; Skin Absorption; Skin Diseases, Viral; Spain; Tacrolimus

Tacrolimus is a potent immunosuppressant used in organ transplant recipients; an ointment formulation is being developed as a therapeutic agent for atopic dermatitis.. Our purpose was to define the pharmacokinetics and evaluate tacrolimus 0.3% ointment as therapy for moderate to severe atopic dermatitis.. Thirty-nine patients, 5 to 75 years of age, received 14 applications over 8 days. Serial blood samples were collected on days 1 and 8, with predose samples collected on days 2 through 7. Overall response and signs/symptoms were rated daily on days 1 through 11. Incidence of adverse events and laboratory profile were determined.. Mean area under the curve (0.9 to 42.5 ng x hr/ml) was highly variable and appeared to be related to size of application area. No systemic accumulation of tacrolimus was observed. Comparison to historical intravenous data indicates that absolute bioavailability of topical tacrolimus was less than 0.5%. Ninety-five percent of patients showed at least good improvement. All adverse events were transient. Burning was the most common application site adverse event and vasodilatation ("flushing/warmth") was the most common nonapplication site adverse event. No drug-related changes in laboratory profile were observed.. The results of this study suggest that tacrolimus 0.3% ointment may be a safe and effective therapy for atopic dermatitis.

Topics: Administration, Cutaneous; Adolescent; Adult; Aged; Area Under Curve; Biological Availability; Child; Child, Preschool; Dermatitis, Atopic; Female; Flushing; Follow-Up Studies; Humans; Immunosuppressive Agents; Incidence; Injections, Intravenous; Male; Middle Aged; Ointments; Remission Induction; Sensation Disorders; Tacrolimus; Vasodilation

A phase II study of the efficacy and safety of FK506, a new potent immunosuppressant, has been conducted in 49 patients with GVHD after allogeneic BMT. Eighteen patients with acute GVHD and 31 with chronic GVHD entered the study. FK506 was administered at an initial dose of 0.05 mg/kg i.v. or 0.15 mg/kg orally twice a day to those whose GVHD had become uncontrollable with cyclosporin and/or other immunosuppressants. The response to FK506 was evaluated in 13 patients with acute and 26 with chronic GVHD. A marked response was observed in 5 and a good response in 2 of 13 patients with acute GVHD. For those with chronic GVHD, the response was marked in 2 patients, good in 10 and poor in 8. The most common adverse effects were renal toxicity (53.1%), followed by nausea and vomiting (30.6%) and a feeding of warmth (18.4%). There was a correlation between renal toxicity and whole blood levels of FK506. The dose should be adjusted to keep a trough level between 15 and 25 ng/ml. FK506 is promising in the treatment of both acute and chronic GVHD, even if it is intractable with other immunosuppressants, and may be most effective if administered early in the course of GVHD.

Topics: Acute Disease; Adolescent; Adult; Azathioprine; Bone Marrow Transplantation; Child; Chronic Disease; Cyclosporine; Female; Flushing; Graft vs Host Disease; Humans; Immunosuppressive Agents; Kidney Diseases; Male; Methotrexate; Middle Aged; Nausea; Prednisolone; Tacrolimus; Treatment Outcome

Topics: Administration, Topical; Drug Eruptions; Flushing; Humans; Immunosuppressive Agents; Tacrolimus

Topics: Administration, Cutaneous; Aged; Alcohol Drinking; Female; Flushing; Food-Drug Interactions; Humans; Immunosuppressive Agents; Tacrolimus; Vitiligo

Topics: Administration, Cutaneous; Adult; Alcohol Drinking; Dermatologic Agents; Erythema; Female; Flushing; Humans; Immunosuppressive Agents; Male; Middle Aged; Tacrolimus; Vitiligo

Topics: Alcohol Drinking; Erythema; Female; Flushing; Humans; Immunosuppressive Agents; Middle Aged; Tacrolimus

Topics: Administration, Topical; Adult; Alcohol Drinking; Dermatitis, Atopic; Dose-Response Relationship, Drug; Drug Interactions; Ethanol; Female; Flushing; Humans; Male; Middle Aged; Rosacea; Tacrolimus

Topics: Drug Interactions; Ethanol; Female; Flushing; Humans; Immunosuppressive Agents; Middle Aged; Ointments; Rosacea; Tacrolimus

The authors report a case of adult-onset minimal change nephrotic syndrome (MCNS) that was resistant to steroid and cyclophosphamide therapy. Introduction of cyclosporin induced an usual cutaneous reaction of severe flushing attacks. Tacrolimus successfully alleviated both the nephrotic syndrome and the cutaneous side effect associated with cyclosporin use. The antiproteinuric mechanisms of tacrolimus and its potential in treating refractory MCNS and other forms of primary glomerulonephritides are discussed.

Topics: Anti-Inflammatory Agents; Cyclophosphamide; Cyclosporine; Drug Eruptions; Drug Resistance; Female; Flushing; Humans; Immunosuppressive Agents; Middle Aged; Nephrosis, Lipoid; Prednisolone; Remission Induction; Steroids; Tacrolimus

Topics: Adult; Cyclosporine; Flushing; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Tacrolimus