the new medications may affect the dose of prograf dramatically, possibly up to 70%. this might make it difficult to control the levels and predispose the person to rejection or renal failure. there are very early studies looking at this. our center is not starting patients on therapy except if someone has a fulminant course of recurrence until more data are available. i am sure that other centers however will embrace the new meds and will be actively treating patients with them.
What are the purported effects on tacrolimus? Has there already been a trial or test? Once a transplant patient's biopsy and lab numbers clearly show him heading down the road to fibrosis and cirrohsis, would it make sense to push for trying the new drugs at least the approved ones for non-transplant such as teleprevir and bocepavir? Otherwise the patient is looking at another transplant which would seem to be quite a negative option.
currently there is no data on its use in the post-liver transplant setting. i would be extremely cautious about using it until more data is available especially since its purported effects on tacrolimus and cyclosporine metabolism are extreme. i am quite confident that there will be clinical trials coming down the road extremely soon.