{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T11:04:03Z","timestamp":1759057443671,"version":"3.37.3"},"reference-count":7,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T00:00:00Z","timestamp":1445558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Abstract<\/jats:title>Drugs and xenobiotics that inhibit the CYP<\/jats:styled-content>\u2010450 isoenzyme 3A4 are associated with increased serum tacrolimus levels. We sought to determine whether there was a temporal association between initiation of dexmedetomidine and increased serum tacrolimus levels. An interaction has not been previously documented. We reviewed tacrolimus levels and dosing in a pediatric patient aged 8 months who had undergone deceased\u2010donor liver transplantation for biliary atresia and later required sedation with dexmedetomidine continuous infusion during the POD<\/jats:styled-content> (212\u2013216). Serum tacrolimus trough levels increased 4\u2010fold from 3.4 to 13.1 ng\/mL (tacrolimus regimen: 1 mg every 12 h) within 21 h of initiating dexmedetomidine. During dexmedetomidine infusion, serum tacrolimus trough levels were maintained with doses that were 25% of baseline tacrolimus dose. Tacrolimus trough levels decreased to below goal range within 30\u201340 h of discontinuation of dexmedetomidine. Data submitted to the U.S. Food and Drug Administration demonstrate that dexmedetomidine inhibits CYP<\/jats:styled-content> 3A4 and may produce adequate liver concentrations that could interfere with tacrolimus metabolism. We suggest that tacrolimus levels should be carefully monitored in children receiving prolonged infusions of dexmedetomidine to avoid adverse events associated with elevated tacrolimus levels.<\/jats:p>","DOI":"10.1111\/petr.12618","type":"journal-article","created":{"date-parts":[[2015,10,23]],"date-time":"2015-10-23T08:28:56Z","timestamp":1445588936000},"page":"155-157","source":"Crossref","is-referenced-by-count":15,"title":["Tacrolimus interaction with dexmedetomidine\u2014a case report"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4090-3004","authenticated-orcid":false,"given":"Sarah R.","family":"Stiehl","sequence":"first","affiliation":[{"name":"Division of Pharmacy Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Squires","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Bucuvalas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trina S.","family":"Hemmelgarn","sequence":"additional","affiliation":[{"name":"Division of Pharmacy Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200241110-00003"},{"key":"e_1_2_6_3_1","unstructured":"Astellas Pharma US Inc.Prograf\u2013tacrolimus. Bethesda MD: National Library of Medicine (US); 1994 [updated Sept 2013]. Available at:http:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=7f667de1-9dfa-4bd6-8ba0-15ee2d78873b(accessed January 6 2015)."},{"key":"e_1_2_6_4_1","unstructured":"U.S. Food and Drug Administration CDER.Review and Evaluation of Pharmacology\/Toxicology Data NDA 21\u2010038. 1999. Available at:http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/99\/21-038_Precedex_pharmr_P3.pdf(accessed January 6 2015)."},{"key":"e_1_2_6_5_1","unstructured":"U.S. Food and Drug Administration CDER.Review and Evaluation of Pharmacology\/Toxicology Data NDA 21\u2010038. 1999. Available at:http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/99\/21-038_Precedex_pharmr_P2.pdf(accessed August 25 2015)"},{"key":"e_1_2_6_6_1","unstructured":"Hospira Inc.Precedex\u2013dexmedetomidine hydrochloride. Bethesda MD: National Library of Medicine (US); 1999 [updated Nov 2014]. Available at:http:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=548a88c0-afda-427e-75ac-5af0cfa2224c(accessed January 6 2015)."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000282046.66773.39"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03133.x"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpetr.12618","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.12618","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T21:11:37Z","timestamp":1695503497000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.12618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,23]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1111\/petr.12618"],"URL":"https:\/\/doi.org\/10.1111\/petr.12618","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"type":"print","value":"1397-3142"},{"type":"electronic","value":"1399-3046"}],"subject":[],"published":{"date-parts":[[2015,10,23]]}}}