Adsorption and pharmacokinetics of cyclosporin A in relation to mode of infusion in bone marrow transplant patients.
Two main factors that affect the pharmacokinetics of cyclosporin A (CsA) during 24-h durable intravenous (DIV) administration have been reported, namely physiological changes after bone marrow transplantation, and blood sampling through indwelling lines. In addition, it has been found that infusion sets made of polyvinyl chloride (PVC) markedly adsorb CsA. We conducted in vitro adsorption studies of CsA on infusion sets, and the administration routes that are used in the treatment of patients with bone marrow transplantation. We also examined the effects of administration route on CsA pharmacokinetics in clinical practice. The in vitro adsorption study using 30-mm segments of lumen from commercially available infusion sets showed that the degree of CsA adsorption per area of lumen made of PVC was significantly higher than that in those made of polyethylene (PE) or polybutadiene (PB), which showed no adsorption of CsA. Due to its adsorption, use of infusion sets made of PVC resulted in about a 40-50% loss of CsA dose, which affected the pharmacokinetic parameters during 24-h DIV, while those made of PE and PB did not. The use of non-PVC infusion sets should allow for accurate monitoring of CsA results, and provide cost benefit in the treatment of bone marrow transplantation.
Shibata
N
N
Department of Hospital Pharmacy, Shiga University of Medical Science, Seta Tsukinowa-cho Otsu, Japan.
Ikuno
Y
Y
Tsubakimoto
Y
Y
Hoshino
N
N
Minouchi
T
T
Yoshio
K
K
Inoue
T
T
Taga
T
T
Ando
A
A
Hodohara
K
K
Ohta
S
S
Fujiyama
Y
Y
Bamba
T
T
Yamaji
A
A
D000327:Adsorption / Q000187:drug effects; D000328:Adult; D001672:Biocompatible Materials / Q000737:chemistry / Q000378:metabolism / Q000494:pharmacology; D016026:Bone Marrow Transplantation; D002070:Butadienes / Q000378:metabolism / Q000494:pharmacology; D016572:Cyclosporine / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D020724:Elastomers; D004867:Equipment Design; D006402:Hematologic Diseases / Q000628:therapy; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation* / Q000592:standards; D008297:Male; D008875:Middle Aged; D020959:Polyethylene / Q000378:metabolism / Q000494:pharmacology; D011108:Polymers / Q000378:metabolism / Q000494:pharmacology; D011143:Polyvinyl Chloride / Q000378:metabolism / Q000494:pharmacology
D001672:Biocompatible Materials; D002070:Butadienes; D020724:Elastomers; D011108:Polymers; D016572:Cyclosporine; D011143:Polyvinyl Chloride; D020959:Polyethylene; C028834:polybutadiene