他克莫司

給藥途徑

禁忌症

• Hypersensitivity to macrolides
• Active systemic infections
• Malignancy (for systemic use)

不良反應

• Topical: local irritation, erythema, pruritus
• Ophthalmic: mild ocular irritation
• Systemic: GI upset (vomiting, diarrhea), nephrotoxicity, neurotoxicity, secondary infections

藥物相互作用

• Ketoconazole · Inhibits CYP3A metabolism, significantly increasing systemic tacrolimus levels · major
• Erythromycin · Inhibits metabolism, increasing tacrolimus levels · major
• Grapefruit juice · Increases systemic absorption and blood levels of tacrolimus · moderate

監測

• Tear production (Schirmer Tear Test) for KCS
• Resolution of skin lesions
• Whole blood trough levels (if used orally)
• Renal and hepatic function (if used orally)

過量

Systemic overdose can lead to severe nephrotoxicity, neurotoxicity (tremors, seizures), and profound immunosuppression. Treatment is supportive and symptomatic. No specific antidote exists.