CYP3A5 metabolizes immunosuppressants like tacrolimus and many other drugs. Only some people are "expressers" of this enzyme, which affects drug levels and transplant outcomes.
Non-Expressor
Drug
Tacrolimus
Effect
Reduced metabolism → higher trough levels
Recommendation
ADJUST. Standard dose may cause supratherapeutic levels.
CPIC Guideline
CPIC Level A
FDA Label
Therapeutic drug monitoring essential
Clinical Action: These recommendations are based on CPIC guidelines and FDA labeling. Discuss results with your healthcare provider or genetic counselor to determine appropriate treatment adjustments.
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