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Peer-Reviewed Publication
CPT Pharmacometrics Syst Pharmacol2026;15(9):e70339.September 1, 2026Journal Article

Precision Dosing of Tacrolimus in Liver Transplantation: Integrating Donor-Recipient CYP3A5 Pharmacogenomics and Drug Interactions.

Virunya Komenkul1,2, Prawat Chantharit3, Piyawat Komolmit4, Bunthoon Nonthasoot5, Athaya Vorasittha5, Anapat Sanpavat6, Sirinporn Suksawatamnuay4, Chandramouli Radhakrishnan7, Thitima Wattanavijitkul1
1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
2Department of Pharmaceutical Care, Faculty of Pharmacy, Silpakorn University, Nakorn Pathom, Thailand.
3Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
4Excellence Center in Liver Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
5Department of Surgery, Faculty of Medicine, Chulalongkorn University & King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
6Department of Pathology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
7Certara, Radnor, Pennsylvania, USA.
PubMed DOI

Abstract

Tacrolimus dosing in liver transplantation is complicated by a narrow therapeutic index and high CYP3A5 genetic variability. While saturable Michaelis-Menten kinetics can explain nonlinearities, identifying saturable parameters from routine clinical data remains challenging. This study aimed to determine the optimal structural model and develop a precision dosing algorithm. A population pharmacoki…

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