Preprandial vs. postprandial pharmacokinetics of cyclosporine in patients with psoriasis.
BACKGROUND
Cyclosporine is usually administered after meals. Preprandial administration of cyclosporine has been shown to enhance drug absorption in patients with nephritic syndrome.


METHODS
We compared the pharmacokinetics of cyclosporine after preprandial and postprandial administration in patients with psoriasis. The study group comprised 12 patients (10 men and two women) with psoriasis vulgaris with a mean age of 47.1 years (range, 27-58 years). The subjects received an oral dose of cyclosporine microemulsion (Neoral) once daily in the morning, either before or after breakfast. The mean dose of cyclosporine was 1.8 mg/kg/day (range, 1.0-2.8 mg/kg/day). Blood samples were collected immediately before and 1, 2, 3, and 4 h after treatment.


RESULTS
After the postprandial administration of cyclosporine, the mean area under the drug concentration-time curve from 0 to 4 h after treatment (AUC0-4) was 1393.5 ng h/mL and the mean maximum drug concentration (Cmax) was 604.1 ng/mL. After preprandial administration, the mean AUC0-4 was 2195.2 ng h/mL and the mean Cmax was 1054.9 ng/mL. AUC0-4 and Cmax were significantly greater after preprandial administration of oral cyclosporine than after postprandial administration.


CONCLUSIONS
Our results suggest that the preprandial administration of cyclosporine enhances drug absorption in patients with psoriasis, potentially allowing the daily dose of cyclosporine to be reduced when compared with postprandial administration.
Umezawa
Yoshinori
Y
Department of Dermatology, Tokai University School of Medicine, Kanagawa, Japan. umeume@is.iccc.u-tokai.ac.jp
Mabuchi
Tomotaka
T
Ozawa
Akira
A
D000284:Administration, Oral; D000328:Adult; D019540:Area Under Curve; D016572:Cyclosporine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period / Q000502:physiology; D011565:Psoriasis / Q000097:blood / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D013997:Time Factors
D007166:Immunosuppressive Agents; D016572:Cyclosporine