PharmGKB: The Pharmacogenomics Knowledge Base

Drug/Small Molecule:
tacrolimus

2D structure

Overview

Generic Names: FK-506; FK5; K506; Tacarolimus; tacrolimus; tacrolimus hydrate
Trade Names: Fujimycin; LCP-Tacro; Prograf; Protopic
PharmGKB Accession Id: PA451578

Description

Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants, and the skin condition vitiligo. It was discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. Tacrolimus is chemically known as a macrolide. It reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex interacts with and inhibits calcineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription. (source: Drug Bank)

Indication

For use after allogenic organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It was first approved by the FDA in 1994 for use in liver transplantation, this has been extended to include kidney, heart, small bowel, pancreas, lung, trachea, skin, cornea, and limb transplants. It has also been used in a topical preparation in the treatment of severe atopic dermatitis. (source: Drug Bank)

ATC Therapeutic Categories

  • D11AX:Other dermatologicals
  • L04AA:Selective immunosuppressants

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

The mechanism of action of tacrolimus in atopic dermatitis is not known. While the following have been observed, the clinical significance of these observations in atopic dermatitis is not known. It has been demonstrated that tacrolimus inhibits T-lymphocyte activation by first binding to an intracellular protein, FKBP-12. A complex of tacrolimus-FKBP-12, calcium, calmodulin, and calcineurin is then formed and the phosphatase activity of calcineurin is inhibited. This prevents the dephosphorylation and translocation of nuclear factor of activated T-cells (NF-AT), a nuclear component thought to initiate gene transcription for the formation of lymphokines. Tacrolimus also inhibits the transcription for genes which encode IL-3, IL-4, IL-5, GM-CSF, and TNF-, all of which are involved in the early stages of T-cell activation. Additionally, tacrolimus has been shown to inhibit the release of pre-formed mediators from skin mast cells and basophils, and to downregulate the expression of FceRI on Langerhans cells. (source: Drug Bank)

Pharmacology

Tacrolimus is a macrolide antibiotic. It acts by reducing peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This inhibits both T-lymphocyte signal transduction and IL-2 transcription. Although this activity is similar to cyclosporine studies have shown that the incidence of acute rejection is reduced by tacrolimus use over cyclosporine. Tacrolimus has also been shown to be effective in the topical treatment of eczema, particularly atopic eczema. It suppresses inflammation in a similar way to steroids, but is not as powerful. An important dermatological advantage of tacrolimus is that it can be used directly on the face; topical steroids cannot be used on the face, as they thin the skin dramatically there. On other parts of the body, topical steroid are generally a better treatment. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic, extensive, primarily by CYP3A4. The major metabolite identified in incubations with human liver microsomes is 13-demethyl tacrolimus. In in vitro studies, a 31-demethyl metabolite has been reported to have the same activity as tacrolimus. (source: Drug Bank)

Protein Binding

75-99% (source: Drug Bank)

Absorption

20% bioavailability; less after eating food rich in fat (source: Drug Bank)

Toxicity

Side effects can be severe and include blurred vision, liver and kidney problems (it is nephrotoxic), seizures, tremors, hypertension, hypomagnesemia, diabetes mellitus, hyperkalemia, itching, insomnia, confusion. LD<sub>50</sub>=134-194 mg/kg (rat). (source: Drug Bank)

Isomeric SMILES Code:

C[C@@H]1C[C@@H]([C@@H]2[C@H](C[C@H]([C@@](O2)(C(=O)C(=O)N3CCCC[C@H]3C(=O)O[C@@H]([C@@H]([C@H](CC(=O)[C@@H](/C=C(/C1)\C)CC=C)O)C)/C(=C\[C@@H]4CC[C@H]([C@@H](C4)OC)O)/C)O)C)OC)OC (source: Drug Bank)

In-Depth Annotations (In-Depth Annotation)

  1. rs1045642 at chr7:86976581 in ABCB1
    Risk or phenotype-associated allele: TT genotype. Phenotype: Decreased tacrolimus levels in a subset of 29 post-operative kidney transplant patients (p < 0.01), and lower incidence of steroid-induced osteonecrosis in 136 patients (OR = 0.1; p = 0.034). Study size: 136 (30 osteonecrosis cases, 106 without osteonecrosis for 2 years post-transplant). Study population/ethnicity: Post-operative kidney transplant patients from Japan. Significance metric(s): OR = 0.10, p = 0.034 (osteonecrosis incidence); p < 0.01 (tacrolimus levels). Type of association: GN; PK; ADR.
    Variant Name:
    ABCB1:3435T>C, Ile1145Ile
    Related Drugs:
    tacrolimus
    Related Diseases:
    Organ Transplantation
    Evidence:
    PMID:14583680
    http://www.pharmgkb.org/.../variant.jsp#ImportantVariantInformationforABCB1-3435
  2. rs1045642 at chr7:86976581 in ABCB1
    Risk or phenotype-associated allele: T allele. Phenotype: Decreased drug-induced neurotoxicity (e.g. convulsion, tremor, leukoencephalopathy) in recipients of liver transplantation associated with the T allele in combination with other factors (e.g. ABCB1:2677G>T/A, tacrolimus trough concentration, aspartate aminotransferase, ratio of graft weight-to-recipient's standard liver volume). Study size: 17 (6 with and 11 without neurotoxicity). Study population/ethnicity: Liver transplant patients from Kyushu University Hospital in Japan. Significance metric(s): chi-squared = 7.91; p < 0.005. Type of association: GN; PK; PD; TOX; ADR.
    Variant Name:
    ABCB1:3435T>C, Ile1145Ile
    Related Drugs:
    tacrolimus
    Related Diseases:
    Drug Toxicity, liver transplantation
    Evidence:
    PMID:12352921
    http://www.pharmgkb.org/.../variant.jsp#ImportantVariantInformationforABCB1-3435

Curated Annotations (Curated Annotation)

  1. rs5030952 at chr2:241191376 in CAPN10
    Risk or phenotype-associated allele: T. Phenotype: Carrying the T allele of SNP-63: rs5030952 was associated with increased risk of posttransplant diabetes in response to tacrolimus. Study size: 214. Study population/ethnicity: Patients who had undergone organ transplantation (kidney) and were treated with tacrolimus. Significance metric(s): OR = 2.45; p = 0.023. Type of association: CO.
    Variant Name:
    SNP-63: rs5030952:C>T
    Related Drugs:
    tacrolimus
    Related Diseases:
    Diabetes Mellitus, Organ Transplantation, Transplantation
    Evidence:
    PMID:19752882
  2. rs1045642 at chr7:86976581 in ABCB1
    (R)-lansoprazole concentrations significantly increased in CYP2C19 extensive metabolizers with the ABCB1 C3435T C allele, but not TT genotype, after renal transplantation and treatment with tacrolimus and lansoprazole.
    Variant Name:
    ABCB1:3435C>T
    Related Drugs:
    lansoprazole, tacrolimus
    Related Diseases:
    Gastroesophageal Reflux, Transplantation
    Evidence:
    PMID:17190370
  3. rs1045642 at chr7:86976581 in ABCB1
    Haplotypes derived from the SNPs 2677G > T (rs2032582) and 3435C > T (rs1045642) do not influence the pharmacokinetics of tacrolimus in renal transplant patients
    Variant Name:
    ABCB1: c.3435C>T, mRNA 3853C>T
    Related Drugs:
    tacrolimus
    Related Diseases:
    Transplantation
    Evidence:
    PMID:15521904
  4. rs1045642 at chr7:86976581 in ABCB1
    Risk or phenotype-associated allele: CC genotype. Phenotype: CC genotype associated with decreased tacrolimus levels after 1 and 3 months (p < 0.05), but no genotypic association at 6, 9, and 12 months (p > 0.05) post-transplantation immunosuppressive therapy. Study size: 83. Study population/ethnicity: Adult lung transplant recipients, from the USA. Significance metric(s): p < 0.05 (1, 3 months Tx); p > 0.05 (6, 9, 12 months Tx). Type of association: GN; PK.
    Variant Name:
    ABCB1:3435T>C, Ile1145Ile
    Related Drugs:
    tacrolimus
    Related Diseases:
    Transplantation
    Evidence:
    PMID:14747421
  5. rs2032582 at chr7:86998554 in ABCB1
    Haplotypes derived from the SNPs 2677G > T (rs2032582) and 3435C > T (rs1045642) do not influence the pharmacokinetics of tacrolimus in renal transplant patients
    Variant Name:
    ABCB1: c.2677G>T/A, mRNA 3095G>T/A, p.Ala893Ser/Thr
    Related Drugs:
    tacrolimus
    Related Diseases:
    Transplantation
    Evidence:
    PMID:15521904
  6. rs776746 at chr7:99108475 in CYP3A, CYP3A5
    Risk or phenotype-associated allele: CYP3A5*3/*3 (rs776746 GG) genotype. Phenotype: Tacrolimus clearance was significantly lower in patients with the nonfunctional CYP3A5 enzyme encoded by the CYP3A5*3/*3 genotype (rs776746 GG) in comparison to carriers of the wild-type CYP3A5*1 ((rs776746 A) allele (p = 0.013).At 1 month after transplantation, creatinine clearance was higher in patients with the CYP3A5*1 allele than in those with CYP3A5*3/*3 (117.5 24.4 vs. 97.2 28.4 ml/min), but not to a statistically significant extent (p = 0.06). Tacrolimus clearance was significantly higher in patients with low (<33%) versus normal hematocrit levels (p = 0.007). The individualization of tacrolimus dosage should be based on weight, hematocrit level, and CYP3A5 polymorphism to maintain therapeutic range. However, interindividual and residual variability remained large even when genetic information was taken into account. In a simulated estimation, 20% of the patients received an overdose (C(0) > 20 ng/ml), and 19% received too low a dose (C(0) < 5 ng/ml), thereby reinforcing the need for monitoring. A standard dosage of 0.15 mg/kg twice daily was associated with underdosing in children with the CYP3A5*1 ((rs776746 A) allele, thus higher dosages (0.2-0.3 mg/kg twice daily) are recommended primarily in children with body weight <20 kg and low hematocrit levels. In contrast, for children with CYP3A5*3/*3 (rs776746 GG) genotype, the lower dosage of 0.1 mg/kg twice daily should be recommended, primarily in those with body weight >40 kg. Study size: 50. Study population/ethnicity: Pediatric kidney transplant patients (29 males) of 10 years mean age (2-18 y.o. range) recruited from nine French centers from 2005 to 2008. Significance metric(s): p = (0.007 - 0.013) Type of association: GN, PK.
    Variant Name:
    CYP3A5*3, intron 3 splicing defect, c.219-237A>G; rs776746 G alllele
    Related Drugs:
    tacrolimus
    Related Diseases:
    Organ Transplantation, Transplantation
    Evidence:
    PMID:19865079
  7. rs776746 at chr7:99108475 in CYP3A, CYP3A5
    Risk or phenotype-associated allele: CYP3A5*3/*3 (rs776746 GG) genotype. Phenotype: In kidney transplant patients, tacrolimus dose-adjusted trough levels were higher in patients carrying the CYP3A5*3/*3 (rs776746 GG) genotype (n = 45) than in carriers of the CYP3A5*1/*3 (rs776746 GA) plus CYP3A5*1/*1 (rs776746 AA) genotypes combined (n = 17), as follows: median and range, 94 (34-398) versus 61 (37-163) ng/mL per mg/kg (p < 0.0001). Thus, patients with the CYP3A5*3/*3 genotype require less tacrolimus to reach target predose concentrations compared with CYP3A5*1 (rs776746 A) allele carriers. Study size: 64. Study population/ethnicity: Renal transplant recipients from the outpatient clinic of the Erasmus Medical Center in Rotterdam in the Netherlands, who had received a renal graft at least 1 year before the start of the study and were administered tacrolimus. Significance metric(s): p < 0.0001 Type of association: GN; PK.
    Variant Name:
    CYP3A5*3, intron 3 splicing defect, c.219-237A>G; rs776746 G alllele
    Related Drugs:
    tacrolimus
    Related Diseases:
    Organ Transplantation, Transplantation
    Evidence:
    PMID:12966368
  8. rs4986910 at chr7:99196460 in CYP3A, CYP3A4, CYP3A5P2
    Risk or phenotype-associated allele: CYP3A4*3 (rs4986910) 445Thr, 1334 C allele Phenotype: Two patients taking tacrolimus carried the CYP3A4*3 (445Thr) allele. The tacrolimus dose-adjusted C(0) in these 2 patients was higher than that in patients with the wild-type (455 Met/Met) genotype (n = 62), as follows: 134.9 (106.6-163.2) versus 83.83 (33.83-397.8) ng/mL per mg/kg, respectively. This difference was also observed at 12 months after transplantation, as follows: 147.3 (117.0-177.5) versus 88.79 (26.0-432.0) ng/mL per mg/kg. Study size: 64. Study population/ethnicity: Renal transplant recipients from the outpatient clinic of the Erasmus Medical Center in Rotterdam in the Netherlands, who had received a renal graft at least 1 year before the start of the study and were administered tacroliums (n = 64). Significance metric(s): Empirical evidence of too small numbers to analyze statistically. Type of association: GN; PK.
    Variant Name:
    CYP3A4*3, c.1334T>C, mRNA 1438T>C, p.Met445Thr; 445Thr allele, 1334 C allele
    Related Drugs:
    tacrolimus
    Related Diseases:
    Organ Transplantation, Transplantation
    Evidence:
    PMID:12966368
  9. rs2740574 at chr7:99220032 in CYP3A, CYP3A4
    Risk or phenotype-associated allele: CYP3A4*1B (rs2740574) G allele. Phenotype: Of 108 renal transplant patients taking cyclosporine (CsA), 94 (87.1%) were carriers of the CYP3A4*1/*1 (rs2740574 AA) wild-type genotype, 9 (8.3%) were heterozygous CYP3A4*1/*1B (rs2740574 AG), and 5 (4.6%) were homozygous CYP3A4*1B (rs2740574 GG). There was no significant genotypic association between the CYP3A4*1B allele and CsA dose requirement (mg/kg), C(0) (ng/ml), or dose-adjusted C(0) (ng/ml per mg/kg) at 3 and 12 months after transplantation. Of 64 patients taking tacrolimus, 7 (10.9%) were heterozygous CYP3A4*1/*1B (rs2740574 AG), and 3 (4.7%) were homozygous CYP3A4*1B (rs2740574 GG). In these 64 patients taking tacrolimus, a trend was observed toward a lower dose-adjusted C(0) for CYP3A4*1B allele carriers (rs2740574 GA or GG), as compared to CYP3A4*1/*1 (rs2740574 AA) genotype carriers (p = 0.01). Comparison between all CYP3A4*1B (rs2740574) G allele carriers (n = 10) and carriers of the CYP3A4*1/*1 (rs2740574 AA) genotype (n = 54) showed a significant difference in tacrolimus dose-adjusted C(0) (p = 0.003), which remained statistically significant at month 12. A significantly higher tacrolimus dose was required in patients carrying the CYP3A4*1B (G) allele compared to CYP3A4*1/*1 (AA) genotype carriers at month 3 (p = 0.01) and at month 12 (p = 0.03). Study size: 108 administered cyclosporine, 64 administered tacrolimus. Study population/ethnicity: Renal transplant recipients from the outpatient clinic of the Erasmus Medical Center in Rotterdam in the Netherlands, who had received a renal graft at least 1 year before the start of the study and were administered CsA (n = 108) or tacroliums (n = 64). Significance metric(s): Not significant for CsA; p = (0.003 - 0.03) for tacrolimus. Type of association: GN; PK.
    Variant Name:
    CYP3A4*1B, CYP3A4-V, 5'-flanking region -392A>G; -392 G allele
    Related Drugs:
    cyclosporine, tacrolimus
    Related Diseases:
    Organ Transplantation, Transplantation
    Evidence:
    PMID:12966368
  10. rs4149117 at chr12:20902747 in SLCO1B3
    Risk or phenotype-associated allele: SLCO1B3: T334. Phenotype: The metabolic ratio of glucuronidated mycophenolic acid (MPAG) to mycophenolic acid (MPA) showed a very significant decrease in carriers of the SLCO1B3 T334 allele (p = 0.0001). Carriers of at least one SLCO1B3 T334 allele (n = 22) had a 1.42-fold higher (p = 0.0003) MPA AUC(0-12 hours) and a 1.38-fold higher (p = 0.0010) Cmax as compared with carriers of the 334GG genotype (n = 48). Patients carrying 334 TT or TC genotypes (n = 22) had significantly higher MPA AUC(4-9 hours) than patients carrying the CC genotype (n = 48; p = 0.0027). However, they also had higher AUC(0-4 h) (p = 0.0008), resulting in an unchanged AUC(4-9 h)/AUC(0-9 h) ratio (p = 0.4945). In the subgroups of patients cotreated with sirolimus (n = 42) and tacrolimus (n = 28), the SLCO1B3: T334 allele was associated with a similar increase in MPA AUC(0-12 h) (p = 0.0074 and p = 0.0651, respectively) and decrease in MPAG/MPA metabolic ratio (p = 0.0517 and 0.0002, respectively); One-third of the patients with the 334 TT or TG genotype (n = 7/22) had MPA AUC(0-12 h) higher than the accepted therapeutic range, as compared with only 8% of patients with the 334GG genotype (n = 4/48). Conversely, among carriers of the 334GG genotype, 40% (n = 19/48) had MPA AUC(0-12 h) below the therapeutic range as compared with 23% (n = 5/22) of patients with the TT or TG genotype. Study size: 70. Study population/ethnicity: Caucasian cohort from the SOPHIE study cotreated with MMF and either sirolimus or tacrolimus. Significance metric(s): p <= 0.05. Type of association: GN; PK
    Variant Name:
    SCLO1B3: exon 4 c.334T>G, mRNA 460T>G, p.Ser112Ala
    Related Drugs:
    mycophenolate mofetil, mycophenolic acid, sirolimus, tacrolimus
    Related Diseases:
    Organ Transplantation
    Evidence:
    PMID:19890249
  11. rs7311358 at chr12:20907027 in SLCO1B3
    Risk or phenotype-associated allele: SCLO1B3 haplotype formed by 112Ser>Ala (rs4149117, 334T>G) and 223Met>Ile (rs7311358, 699G>A). Phenotype: HEK293 cells transiently expressing the SCLO1B3 334G-699A haplotype or reference haplotype were incubated in the presence of increasing concentrations of mycophenolic acid phenyl-glucuronide (MPAG) for 10 min. The uptake of MPAG according to the SCLO1B3 334G-699A haplotype was markedly lower than in cells expressing the reference sequence 334T-669G. Type of association: GN; FA; PK
    Variant Name:
    SCLO1B3: exon 7 c.699G>A, mRNA 825G>A, p.Met233Ile
    Related Drugs:
    cyclosporine, mycophenolate mofetil, sirolimus, tacrolimus
    Related Diseases:
    Organ Transplantation
    Evidence:
    PMID:19890249
  12. rs2306283 at chr12:21221005 in SLCO1B1
    Risk or phenotype-associated allele: SLCO1B1*15 defined by rs2306283 Asn130Asp (338A>G) and rs4149056 Val174Ala (521T>C). Phenotype: SLCO1B1*15 allele was associated with higher mycophenolic acid (MPA) AUC(0-12 hours) (p = 0.0246) and lower ratio of MPAG (MPA glucuronide)/MPA (p = 0.0267), but no association with MPAG AUC(0-9 h). Study size: 70. Study population/ethnicity: Caucasian cohort from the SOPHIE study cotreated with mycophenylate mofetil (MMF) and either sirolimus or tacrolimus. Significance metric(s): p < 0.03. Type of association: GN; PK
    Variant Name:
    SCLO1B1: SLCO1B1*15 defined by rs2306283 Asn130Asp (338A>G) and rs4149056 Val174Ala (521T>C)
    Related Drugs:
    mycophenolate mofetil, mycophenolic acid, sirolimus, tacrolimus
    Related Diseases:
    Organ Transplantation
    Evidence:
    PMID:19890249
  13. rs4149056 at chr12:21222816 in SLCO1B1
    Risk or phenotype-associated allele: SLCO1B1*15 defined by rs2306283 Asn130Asp (338A>G) and rs4149056 Val174Ala (521T>C). Phenotype: SLCO1B1*15 allele was associated with higher mycophenolic acid (MPA) AUC(0-12 hours) (p = 0.0246) and lower ratio of MPAG (MPA glucuronide)/MPA (p = 0.0267), but no association with MPAG AUC(0-9 h). Study size: 70. Study population/ethnicity: Caucasian cohort from the SOPHIE study cotreated with mycophenylate mofetil (MMF) and either sirolimus or tacrolimus. Significance metric(s): p < 0.03. Type of association: GN; PK
    Variant Name:
    SCLO1B1: SLCO1B1*15 defined by rs2306283 Asn130Asp (338A>G) and rs4149056 Val174Ala (521T>C)
    Related Drugs:
    mycophenolate mofetil, mycophenolic acid, sirolimus, tacrolimus
    Related Diseases:
    Organ Transplantation
    Evidence:
    PMID:19890249
Variant names are different names that have been used in the literature and other resources to refer to the same variant.

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
ABCB1
  • CO
  • PD
  • PK
  • FA
  • GN
Publications, Variants
Phenotype data available Genotype Data Available Literature annotations available Not annotated
ABCC2
  • CO
  •   
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
ABCG2
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
CAPN10
  • CO
  •   
  •   
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP2C8
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Has annotations
CYP2J2
  • CO
  •   
  •   
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
  •   
  •   
  • PK
  •   
  • GN
Publications, Variants
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
  • CO
  • PD
  • PK
  •   
  • GN
Publications, Variants
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
  • CO
  • PD
  • PK
  •   
  • GN
Publications, Variants
No phenotype data Genotype Data Available No literature annotations Not annotated
CYP3A5P2
  •   
  •   
  •   
  •   
  •   
Variants
No phenotype data Genotype Data Available Literature annotations available Not annotated
CYP3A7
  •   
  •   
  • PK
  •   
  • GN
Publications
Phenotype data available No genotype data Literature annotations available Not annotated
NFATC1
  •   
  •   
  •   
  • FA
  •   
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
RCAN1
  •   
  •   
  •   
  • FA
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
SLC30A8
  •   
  •   
  •   
  • FA
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Has annotations
SLCO1B1
  •   
  •   
  • PK
  • FA
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
SLCO1B3
  •   
  •   
  • PK
  •   
  • GN
Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
UGT1A8
  •   
  •   
  • PK
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
UGT1A9
  •   
  •   
  • PK
  •   
  • GN
Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
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TM7SF4 Curated Annotation Not bad for our first attempt - especially given the prowess (and budgets) of the opposition, ceridian self services, vpov, brochure printer service, wrgg, (source: FDA Labels)
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TM7SF4 Curated Annotation I have not understood your message., borgato casino atlantic city, 2215, (source: PubChem Compound)
TM7SF4 Curated Annotation I have met many people throughout my life who have shown courage and determination such as yours and this has always made me feel very humble, fashion phototgraphy, 6561, car transporting jobs, whn, sharaz wine and food, fyyu, cheap domestic airfares china, >:D, (source: PharmGKB)
TM7SF4 Curated Annotation Hi there By the way, you have made the promise, to come to Eurospeedway if practical. hearing centers los angeles Very cool! chicago airport shuttel service, Thank you for your site (source: ATC)
TM7SF4 Curated Annotation Hello, Hard to say anything more except perhaps it is great that because of being very positive and strong, because of having a high self-esteem, you instead of becoming marshal-victim, become a really motivating marshal, los angeles time entertainment, =((, san fernando valley cab los angeles, :[, (source: PubChem Substance)
TM7SF4 Curated Annotation We all applaud the wonderful gesture you have taken under your belt. , denver international airlines, 420, does my credit card offer insurance coverage on a rental car, 3823, (source: ATC)
TM7SF4 Curated Annotation Well done with this - it was all a really interesting read! working on a BTRA web site at the moment - will let you know the details as & when! btra, caribbean adult vacations, 290, (source: MeSH)
TM7SF4 Curated Annotation Would I have the nerve to pull it off? That's when your real friends, your brother & sister marshals count, horace mann call center, =-D, casters air film, 8(((, (source: PubChem Compound)
TM7SF4 Curated Annotation well, This web-site is the coolest! nick heitkamp aurora colorado memorial service Perfect site, i like it! summit grand sierra or, cape canaveral florida chamber of commerce now, ohio university hospital but, national weather servics dress, reverse phone number look ups south africa key, japenise steakhouse orlando florida, Shrug. (source: FDA Labels)
TM7SF4 Curated Annotation A shining beacon of how to be human beings, small frame 9mm pistol, 238241, small business organizations cape coral florida, 336117, (source: PubChem Compound)
TM7SF4 Curated Annotation I hope one day to meet you in person, and invite you to join us in the States once again to work with us, video camera filters, qwrii, best digital video recorder, 637615, (source: PharmGKB)
TM7SF4 Curated Annotation Not much on my mind right now. Today was a complete loss. So it goes. I've just been sitting around waiting for something to happen. I've basically been doing nothing , but I guess it doesn't bother me., william miles and fairfield, dfy, doit caribbean, =-PPP, (source: ATC)
TM7SF4 Curated Annotation Hi! lonely hort!, Mp3 video, 291, (source: FDA Labels)
TM7SF4 Curated Annotation Best regards from the German Le Mans post 106 marshals. Caron is just as excited about getting her MSA registration & doing her first training days aglilent airfare do you see main street village apartments condition, caribbean am radio stations, i love you (source: PubChem Compound)
TM7SF4 Curated Annotation Perhaps the next time we are over (probably next year as we were just there) we can get together, cheap airfare to universal studios in florida, 8DD, fairfield art, %-[[[, (source: PubChem Compound)
TM7SF4 Curated Annotation hey everyone! There was an title "ALEX ZANARDI MEETS AMPUTEE MARSHAL" replacement parts carnival king it I shall necessarily tell about him to the friends. rooftop terraces of new york city when, mastercard carnival sea miles, so hold. (source: ATC)
FKBP1A Uncurated Annotation (source: Drug Bank)

The following drugs are in curated knowledge about this drug.

  Drug Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
amlodipine
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
calcium channel blockers
  •   
  •   
  • PK
  •   
  •   
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
fluconazole
  •   
  •   
  • PK
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
mycophenolate mofetil
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
mycophenolic acid
  •   
  •   
  • PK
  •   
  •   
Publications

A list of non-curated publications that mention this drug along with other drugs is available.

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Diabetes Mellitus
  • CO
  •   
  •   
  • FA
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Drug interaction with drug
  •   
  •   
  • PK
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Drug Toxicity
  • CO
  •   
  •   
  •   
  •   
Publications
No phenotype data No genotype data Literature annotations available Not annotated
Kidney Diseases
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
liver transplantation
  • CO
  •   
  • PK
  • FA
  • GN
Publications, Variants
No phenotype data No genotype data Literature annotations available Not annotated
Nephritis, Interstitial
  • CO
  •   
  •   
  •   
  • GN
Publications
No phenotype data No genotype data Literature annotations available Not annotated
nephrotoxicity
  • CO
  •   
  •   
  •   
  • GN
Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
Organ Transplantation
  • CO
  •   
  • PK
  •   
  • GN
Publications, Variants
No phenotype data No genotype data Literature annotations available Not annotated
Transplantation
  • CO
  •   
  • PK
  • FA
  • GN
Publications, Variants

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Curated Phenotype Datasets

These datasets are sorted alphabetically by title.

  1. Tacrolimus dosing and outcome in lung transplant patients
    • Genotype data available
    • Phenotype data available
    • No literature annotations
    • Not annotated
    • CO
    • PK
    Submitted by Burckart GJ involving ABCB1, CYP3A5, tacrolimus, and Organ Transplantation
  2. Tacrolimus dosing and Steroid Weaning in pediatric heart transplant patients
    • Genotype data available
    • Phenotype data available
    • No literature annotations
    • Not annotated
    • CO
    • PK
    Submitted by Burckart GJ involving ABCB1, CYP3A4, CYP3A5, glucocorticoids, prednisone, tacrolimus, and Organ Transplantation

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Physicochemical determinants of human renal clearance
  2. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

Downloads

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LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00864
KEGG Compound ID:
C01375
PubChem Compound ID:
439492
PubChem Substance ID:
4572

Common Searches

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Search Medline Plus
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Search CTD

Non-Curated Publications

A list of non-curated publications that mention this drug is available.

PharmGKB integrates drug information from different sources: DrugBank, Open Eye Scientific Software.
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