title: Benefits of pre-emptive dose reduction for Sandimmune to Neoral conversion in stable renal transplant recipients.
abstract: In an effort to minimize nephrotoxicity resulting from greater exposure to cyclosporine after Sandimmune to Neoral conversion, we compared two conversion regimens using different dosing ratios. Serial serum creatinine concentrations and trough cyclosporine levels were measured in 26 patients converted from Sandimmune to Neoral using a 1:0.8 dosing ratio (Group 1) and compared to those of 26 patients converted using a 1:1 dosing ratio (Group 2). The percentage change in peak serum creatinine concentration after conversion was greater in Group 2. However, at last follow-up, the dose reductions in each group were comparable. Following conversion, patients in Group 1 required fewer dose adjustments and follow-up blood tests. Compared to conversion using a 1:1 dosing ratio, conversion from Sandimmune to Neoral using a 1:0.8 ratio results in comparable dose reductions and less short-term nephrotoxicity, while requiring less frequent laboratory monitoring.
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA. deh5@po.cwru.edu
authors.forename: D E
authors.initials: DE
authors.lastname: Hricik
authors.forename: A
authors.initials: A
authors.lastname: Dixit
authors.forename: T C
authors.initials: TC
authors.lastname: Knauss
authors.forename: V
authors.initials: V
authors.lastname: Donley
authors.forename: M R
authors.initials: MR
authors.lastname: Bartucci
authors.forename: J A
authors.initials: JA
authors.lastname: Schulak
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004304:Dosage Forms; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged
chemical_list: D004304:Dosage Forms; D016572:Cyclosporine; D003404:Creatinine