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Enhanced Oral Cyclosporine Absorption With Water‐Soluble Vitamin E Early After Liver Transplantation
Author(s) -
Pan ShiHui,
Lopez Richard R.,
Sher Linda S.,
Hoffman Allen L.,
Podesta Luis G.,
Makowka Leonard,
Rosenthal Philip
Publication year - 1996
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1996.tb02916.x
Subject(s) - dose , medicine , oral administration , whole blood , transplantation , pharmacology , gastroenterology
We evaluated the effect of Liqui‐E, a water‐soluble vitamin E preparation, on cyclosporin A (CyA) whole blood concentration in liver transplant recipients, and its impact on the cost of CyA. Patients were 26 liver transplant recipients (19 adults, 7 children) who were unable to achieve and maintain therapeutic CyA whole blood concentrations with the standard recommended oral daily dose in the early post‐transplant period. Liqui‐E 6.25 IU/kg orally was administered with CyA every 12 hours (median time of starting Liqui‐E day 14.5). With Liqui‐E, the daily oral CyA requirements (mean ± SD) were decreased in adults from 22.6 ± 8.9 to 16.2 ± 7.3 mg/kg/day (p<0.001) and in children from 78.6 ± 34.1 to 53.7 ± 35.0 mg/kg/day (pl0.02); intravenous administration of CyA was unnecessary. The CyA trough concentrations (mean ± SD) before and after Liqui‐E were 670 ± 186 and 1012 ± 216 ng/ml, respectively, in adults (pl0.001) and 732 ± 187 and 1052 ± 166 ng/ml, respectively, in children (pl0.01). When given with Liqui‐E, the daily cost of CyA decreased by 26% in both adults and children. No clinical or biochemical evidence of Liqui‐E toxicity was observed. Thus its administration in the early post‐transplantation period can enhance CyA absorption in adults and children who are unable to achieve adequate whole blood concentrations with the usual recommended oral dosages. In addition, a significant cost saving can be realized by coadministration.