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The recommended starting dose of Prograf injection is 0.03-0.05 mg/kg/day in kidney and liver transplant and 0.01 mg/kg/day in heart transplant given as a continuous IV infusionAdult patients should receive doses at the lower end of the dosing rangeConcomitant adrenal corticosteroid therapy is recommended early post-transplantation.

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Monitoring of tacrolimus blood concentrations in conjunction with other laboratory and clinical parameters is considered an essential aid to patient management for the evaluation of rejectiontoxicitydose adjustments and complianceObserved whole blood trough concentrations can be found in Table 1Factors influencing frequency of monitoring include but are not limited to hepatic or renal dysfunctionthe addition or discontinuation of potentially interacting drugs and the post-transplant timeBlood concentration monitoring is not a replacement for renal and liver function monitoring and tissue biopsiesData from clinical trials show that tacrolimus whole blood concentrations were most variable during the first week post-transplantation.

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