Effect of the transition from intravenous to oral dosing on cyclosporin-A trough concentrations in liver transplant patients.
Cyclosporin A (CsA) absorption is low and variable after liver transplantation, and during the intravenous-oral transition period CsA concentrations may not be maintained within the therapeutic range. Trough whole blood CsA concentrations were measured by high-performance liquid chromatography before and after the transition period in 27 liver transplant patients. Mean (SD) CsA concentrations decreased from 291 (92) to 198 (96) ng/ml (p < 0.001). When analyzed on individual charts, a decrease was observed in 15 of 27 patients and it was associated with a duration of 2 days or less (p < 0.01) and a total bilirubin value below 3.5 mg/dl (p < 0.05). Our results show that, despite therapeutic drug monitoring, CsA blood concentrations may decrease during the intravenous-oral transition period.
Maboundou
C W
CW
Department of Clinical Pharmacology, Besançon University Hospital, France.
Paintaud
G
G
Bresson-Hadni
S
S
Mantion
G
G
Miguet
J P
JP
Bechtel
P R
PR
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001682:Biological Availability; D002851:Chromatography, High Pressure Liquid; D016572:Cyclosporine / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D007275:Injections, Intravenous; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D016572:Cyclosporine