{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:34:42Z","timestamp":1791689682805,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,15]],"date-time":"2016-06-15T00:00:00Z","timestamp":1465948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tacrolimus (<jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content>) is an immunosuppressive drug used by oral administration. Intravenous (<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> administration is required under conditions of gastrointestinal diseases or abdominal surgery at the onset of paralytic ileus. The infusion formulation needs a large dilution and therefore a careful technical management during continuous infusion by 24 h and may determine anaphylaxis, cardiac arrhythmia, <jats:styled-content style=\"fixed-case\">QT<\/jats:styled-content> prolongation and torsades de pointes. Sublingual (<jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> administration was suggested as an alternative route.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>The aim of this study was to compare in the same kidney transplanted patients the <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> pharmacokinetic profiles by both the routes coupled with the pharmacoeconomic analysis. The study enrolled eight subjects undergoing renal transplantation and treated with <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> and methylprednisolone. <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> was administered by oral route at the scheduled dosage while the 50% of oral dosage was used by <jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content> route, taking into account the absence of liver first pass.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Except for <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>, which resulted significantly increased after oral administration, all exposure parameters were not significantly different between the two routes of administration. Analysis of dose\u2010adjusted exposure parameters showed significant increases in <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> and <jats:italic>C<\/jats:italic><jats:sub>min<\/jats:sub> after <jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content> administration confirming a better bioavailability of the <jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content> route compared with oral route. Cost saving was obtained using the <jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content> rather than the <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> route of <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When oral administration of <jats:styled-content style=\"fixed-case\">TCR<\/jats:styled-content> is not advised, <jats:styled-content style=\"fixed-case\">SL<\/jats:styled-content> delivery represents an attractive option to <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> administration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12644","type":"journal-article","created":{"date-parts":[[2016,5,30]],"date-time":"2016-05-30T13:26:50Z","timestamp":1464614810000},"page":"651-657","source":"Crossref","is-referenced-by-count":9,"title":["Sublingual administration improves systemic exposure of tacrolimus in kidney transplant recipients: comparison with oral administration"],"prefix":"10.1111","volume":"46","author":[{"given":"Stefano","family":"Federico","sequence":"first","affiliation":[{"name":"Department of Public Health Section of Nephrology and Renal Transplantation \u201cFederico II\u201d University Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Carrano","sequence":"additional","affiliation":[{"name":"Department of Public Health Section of Nephrology and Renal Transplantation \u201cFederico II\u201d University Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Sabbatini","sequence":"additional","affiliation":[{"name":"Department of Public Health Section of Nephrology and Renal Transplantation \u201cFederico II\u201d University Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Nappi","sequence":"additional","affiliation":[{"name":"Department of Public Health 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