Cyclosporin monitoring in Australasia: 2002 update of consensus guidelines.
Therapeutic drug monitoring of cyclosporin (CsA) has been established as part of the routine clinical treatment of patients following organ transplantation for more than 20 years, and based on contemporary knowledge, many consensus guidelines have been published to assist clinics and laboratories attain optimal strategies for patient care. This article addresses the newer directions in CsA monitoring, with particular reference to the Australasian situation that has evolved since the 1993 Australasian guideline. These changes have included the introduction of alternative assay methodologies, changed CsA formulation from Sandimmun to Neoral throughout Australasia, and alternatives to trough concentration (C0) monitoring, especially 2-hour concentration (C2) monitoring and associated validated dilution protocols to accurately quantitate the higher whole blood CsA concentrations. The revision was prepared following a recent survey of all Australasian CsA-monitoring laboratories where discordant practices were evident.
Morris
Raymond G
RG
Department of Cardiology and Clinical Pharmacology, The Queen Elizabeth Hospital, Woodville, South Australia, Australia.
Ilett
Kenneth F
KF
Tett
Susan E
SE
Ray
John E
JE
Fullinfaw
Robert O
RO
Cooke
Russell
R
Cook
Stephen
S
D019540:Area Under Curve; D001208:Asia; D001315:Australia; D016572:Cyclosporine / Q000032:analysis* / Q000097:blood / Q000493:pharmacokinetics; D004110:Diltiazem / Q000627:therapeutic use; D004347:Drug Interactions; D016903:Drug Monitoring; D016568:Drugs, Generic; D017408:Guidelines as Topic; D006801:Humans; D007118:Immunoassay; D007201:Indicator Dilution Techniques; D011786:Quality Control; D015203:Reproducibility of Results
D016568:Drugs, Generic; D016572:Cyclosporine; D004110:Diltiazem