title: Therapeutic monitoring of calcineurin inhibitors for the nephrologist.
abstract: The calcineurin inhibitors (CNI) cyclosporine and tacrolimus remain the backbone of immunosuppression for most kidney transplant recipients. Despite many years of experience, protocols that optimize efficacy with minimal toxicity remain a subject of debate. Nevertheless, studies of the pharmacokinetic properties of the CNI, particularly cyclosporine, have led to improved dosing strategies. The purpose of this article is to review the current understanding of CNI pharmacokinetics and its relevance to proper dosing and monitoring of these medications. This article also reviews the trials that have helped to define the optimal dosages and discusses the effect of adjunctive immunosuppressive agents on CNI pharmacokinetics and dosing.
authors: Division of Nephrology, University Health Network, Toronto General Hospital, Toronto, Ontario, Canada.
authors: Jeffrey
authors: J
authors: Schiff
authors: Edward
authors: E
authors: Cole
authors: Marcelo
authors: M
authors: Cantarovich
mesh_terms: D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000097:blood / Q000627:therapeutic use*; D016903:Drug Monitoring; D006801:Humans; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use*; D016030:Kidney Transplantation; D009398:Nephrology; D016559:Tacrolimus / Q000097:blood / Q000627:therapeutic use*
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus