[Current status of therapeutic drug monitoring for immunosuppressive drugs].
Therapeutic drug monitoring(TDM) is advocate to provide information about the adequacy of a dosing regimen or likelihood of toxicity associated with drug. Such situations include large intra- and inter-individual variabilities in pharmacokinetics; correlation between drug concentrations and toxicity or between concentrations and efficacy; narrow therapeutic interval, meaning toxic symptoms close to concentration with full therapeutic effect; and absence of appropriate parameter to recognize pharmacological effect. Current clinical immunosuppressive regimens consist of combinations of drugs, to allow a reduction in the individual drug doses as a means widening the therapeutic interval and reduction the likelihood of individual drug toxicity. With the recent introduction of new immunosuppressive drugs, there is an unprecedented interest in TDM for immunosuppressive drugs. In this review I discuss the current status of pharmacokinetic monitoring for cyclosporine, tacrolimus and mycophenolate mofetil.
Uchida
Kazuharu
K
Department of Transplant Surgery, Kidney Center, Nagoya Daini Red Cross Hospital.
D016572:Cyclosporine / Q000493:pharmacokinetics*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D016559:Tacrolimus / Q000493:pharmacokinetics*
D016572:Cyclosporine; D009173:Mycophenolic Acid; D016559:Tacrolimus