Effects of different routes of cyclosporin A administration on blood levels in patients undergoing bone marrow transplantation.
This follow-up study has been carried out on 15 bone marrow transplant recipients treated intravenously with cyclosporin A (CsA) as a bolus (1.25-2.5 mg/kg/12 h) or by continuous infusion (1-3 mg/kg/24 h) from -2 until the 21st day after transplantation. All patients were subsequently treated with CsA orally at a starting dose of 6.25 mg/kg/12 h; this starting dose was then adjusted on the basis of CsA blood levels until the 60th day after transplantation, followed by progressive reduction and withdrawal within 6-12 months. In whole blood, trough levels of polyclonal (P) and monoclonal (M) CsA were monitored by a FPIA method and the polyclonal/monoclonal ratio (P/M) was calculated. This ratio was lower during CsA administration as a bolus or by continuous infusion than during oral administration; the decrease was statistically significant. This difference was probably due to first-pass metabolism which occurs in the liver and gut after oral administration.
Capone
D
D
Department of Neurosciences, School of Medicine, Federico II University, Naples, Italy.
De Marino
V
V
Fontana
R
R
Notaro
R
R
De Marino
V
V
Pisanti
N
N
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000097:blood; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged
D007166:Immunosuppressive Agents; D016572:Cyclosporine