Kinetics of generic tacrolimus in heart transplantation: A cautionary note

JOURNAL OF HEART AND LUNG TRANSPLANTATION

卷:40

Article

Il'Giovine, Zachary J.¹  Williams, J. Bradley¹  Mason, R. Preston^2,3  Sherratt, Samuel C. R.^3,4  Hsich, Eileen M.¹  Lever, Harry¹  Mehra, Mandeep R.²  Starling, Randall C.¹ 

[1] Cleveland Clin Fdn, Dept Cardiovasc Med, Heart Vasc & Thorac Inst, Kaufman Ctr Heart Failure Treatment & Recovery, 9500 Euclid Ave, Cleveland, OH 44195 USA

[2] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Cardiovasc Div, Boston, MA 02115 USA

[3] Elucida Res LLC, Beverly, MA USA

[4] Univ New Hampshire, Dept Mol Cellular & Biomed Sci, Durham, NH 03824 USA

关键词: Immunosuppression;    tacrolimus;    rejection;    pharmacology;   

DOI  :  10.1016/j.healun.2021.03.009

来源: Elsevier

【 摘 要 】

Tacrolimus is a core component of immunosuppressive regimens. This study compared active pharmaceutical ingredient (API) and dissolution kinetics of branded tacrolimus and formulations from three generic manufacturers (Mylan, Dr. Reddy's, Intas) including samples from patients who suffered acute cardiac allograft rejection. Generic samples showed similar API content compared to branded samples with no major impurities. Capsules that underwent uniformity testing had consistent capsule-to-capsule API. Dissolution testing showed similar profiles between branded tacrolimus and Mylan, but notable differences with Dr. Reddy's and Intas. The approximate maximal inhibitory concentration (IC50) was highest in branded tacrolimus (29 minutes), followed by Mylan (26 minutes), Dr. Reddy's (19 minutes), and Intas (14 minutes) (Student-Newman-Keuls Multiple Comparisons Test; overall ANOVA: p = 0.0199, F = 6.469). This study suggests that the bioavailability of certain generic tacrolimus formulations peak significantly earlier than branded tacrolimus. Further study is needed to determine whether these differences are clinically relevant. (C) 2021 International Society for Heart and Lung Transplantation. All rights reserved.

【 授权许可】

Free