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Cyclosporine pharmacokinetics and blood pressure responses after conversion to once‐daily dosing in maintenance liver transplant patients
Author(s) -
Kovarik John M,
Villamil Federico,
Otero Alejandra,
Levy Gary,
Lynch Stephen,
Cillo Umberto,
Fischer Lutz,
Nashan Björn,
Pollard Steve,
Carlis Luciano De
Publication year - 2007
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2007.00747.x
Subject(s) - medicine , dosing , pharmacokinetics , liver transplantation , blood pressure , pharmacology , anesthesia , intensive care medicine , transplantation
In this six‐month randomized multicenter trial, we characterized cyclosporine pharmacokinetics and blood pressure profiles in maintenance liver transplant patients converting from twice‐daily to once‐daily cyclosporine dosing. A total of 60 patients were randomized as follows: group A (n = 14) maintained twice‐daily dosing; group B (n = 24) converted to once‐daily dosing at the same total daily dose as pre‐conversion; and group C (n = 22) was treated the same as group B but with a 25% reduction in dose and C2 at two to three wk post‐conversion. After conversion to once‐daily dosing in groups B and C, trough blood levels (C0) did not change; whereas, C2 nearly doubled. The total daily area under the concentration–time curve AUC(0–24) increased by 29%. After the dose reduction in group C, the AUC(0–24) was similar to the pre‐conversion value. Hence, a 25–30% dose reduction can be considered after conversion to once‐daily dosing. In the study observation period in weeks 4–15, the median (25–75 percentile) C2 was 568 (469–750) ng/mL for group A; 1055 (840–1224) ng/mL for group B; and 764 (575–959) ng/mL for group C. Conversion to once‐daily dosing was associated with a decrease in nighttime mean arterial blood pressure.