Influence of bile on cyclosporin absorption from microemulsion formulation in primary liver transplant recipients.
We analysed the absorption, after oral application, of a new galenic form of cyclosporin A (CyA-NOF) in liver-grafted patients (n = 12) during the 1st week (days 2-4) after transplantation. Pharmacokinetic profiling was performed with an open or clamped T tube in situ or with the T tube absent. The pharmacokinetic parameters of CyA-NOF were influenced by T tube clamping and bile diversion. The highest AUC, Cmax and earliest Tmax values were found in patients without a T tube in situ, indicating that absorption of CyA-NOF in patients during the early course after liver transplantation is not bile-independent. CyA-NOF, at a dose of 7.5 mg/kg, was enterally absorbed with appropriate AUC and Cmax levels. Patients receiving a starting dose of 7.5 mg/kg were successfully maintained on CyA-NOF during the subsequent clinical course.
Winkler
M
M
Klinik für Abdominal- und Transplantationschirurgie, Medizinische Hochschule Hannover, Germany.
Ringe
B
B
Oldhafer
K
K
Kattner
A
A
Färber
L
L
Maibücher
A
A
Wonigeit
K
K
Pichlmayr
R
R
D000042:Absorption; D000284:Administration, Oral; D000328:Adult; D001646:Bile / Q000502:physiology*; D016572:Cyclosporine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D004655:Emulsions; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D008107:Liver Diseases / Q000378:metabolism / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged
D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine