Effect of glecaprevir/pibrentasvir on weight‐adjusted tacrolimus trough/dose ratios in heart and kidney transplant recipients

Objective The pharmacokinetic implications of direct‐acting antiviral (DAA) use on tacrolimus posttransplant are unknown. This study sought to investigate the effects of glecaprevir/pibrentasvir (G/P), a CYP3A4 substrate and inhibitor, on weight‐adjusted tacrolimus (FK) trough/dose ratio (T/D) following heart or kidney transplantation. Material and methods This was a single‐center, retrospective analysis of hepatitis C virus (HCV) viremic donors to HCV negative heart or kidney transplant recipients who received 12 weeks of G/P therapy. Weight‐adjusted T/D was assessed while patients were at steady‐state before, during, and after G/P treatment. Forty‐one HCV negative recipients (three heart, 38 kidney) were evaluated. Results The weight‐adjusted T/D significantly increased during G/P treatment (119.31, IQR 88–173.8) compared to before G/P treatment (67.4, IQR 53.4–115.9) (p