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. 2019 Oct 26;59(5):591–603. doi: 10.1007/s40262-019-00831-8
A validated dosing algorithm could poorly predict the individual starting dose of tacrolimus following renal transplantation in cytochrome P450 3A5 expressers receiving a kidney from a deceased donor.
The dosing algorithm was improved and the weight-normalized starting dose of tacrolimus should be higher in patients with lower bodyweight and in those who are cytochrome P450 3A5 expressers.
This study demonstrates that even though a model is validated on paper, it is not necessarily effective in clinical practice. Dosing algorithms should first be tested in prospective studies.