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Tacrolimus + ketoconazole is a drug combination used in kidney transplant recipients. Ketoconazole increases blood levels of tacrolimus through inhibition of cytochrome P450 microsomal enzymes. This combination allows for significant reduction in tacrolimus dosage (typically 45-59%) while maintaining therapeutic immunosuppressive levels, which substantially reduces treatment costs. However, studies show conflicting results regarding safety and efficacy, with some research indicating an increased risk of acute rejection with long-term use.
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