Extended release once a day tacrolimus

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Purpose of review

This article provides an update of the literature on the use of extended release once-daily tacrolimus in solid organ transplant recipients.

Recent findings

Medication nonadherence occurs in a substantial proportion of patients posttransplant and is associated with worse outcomes. Multiple daily dosing is associated with an increased risk for nonadherence. Several studies have indicated once-daily dosing of medications and reduced complexity improve medication adherence. The extended release formulations of tacrolimus have been developed with the potential benefits of improving adherence, and hence safety and outcomes. Astagraf XLTM (Advagraf in Europe) and Envarsus XR. are the two extended release once-daily tacrolimus formulations that have recently become available for clinical use and provide promising alternatives to the treatment choices available for immunosuppression in solid organ transplant recipients.


Although extended release tacrolimus shows promise in improving patient adherence to transplant medication therapy, further studies are needed to confirm improved compliance and to assess long-term safety and efficacy.

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