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TDM for Immunosuppressants

Drugs used to inhibit the immune system are part of standard treatment after transplant surgeries. Unfortunately, these life-saving drugs also cause hepatotoxicity and nephrotoxicity with high concentrations. The reason drug monitoring is used for immunosuppressants is to ensure that concentrations are adequate to suppress the immune response and prevent rejection yet not high enough to cause liver failure or severe immunodeficiency.

Examples of immunosuppressants that are monitored by TDM include:

  • Cyclosporine
  • Methotrexate (this drug is also used as an anti-neoplastic drug)
  • Tacrolimus
  • Sirolimus