Tacrolimus Dosing Challenges in an African American Child

It has been suggested that African Americans have decreased effectiveness with immunosuppressive drugs. Data regarding the pharmacokinetics of tacrolimus in African Americans are limited. We present the case of an African American child in whom management of nephrotic syndrome caused by focal segmental glomerulosclerosis has been challenging due to unpredictable patient specific pharmacokinetic disposition of tacrolimus. Racial differences have been documented in literature to have an important impact on the pharmacokinetics and pharmacodynamics of certain drugs. As a result, African American patients may require larger doses or more frequent administration of certain medications to achieve therapeutic efficacy compared to Caucasians and other ethnic groups.