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KMID : 0869620070240010061
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Journal of Korean Society of Hospital Pharmacists
2007 Volume.24 No. 1 p.61 ~ p.64
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Deriving Pharmacokinetic Parameters of Cyclosporine in Pediatric Allo-HSCT Patients
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Youn Kyung-Ah
Lee Yong-Hwa
Park Kyoung-Ho
Son In-Ja
Oh Jung-Mi
Cho Young-Hwan
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Abstract
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Cyclosporine has considerable interindividual variability in pharmacokinetics and a relatively narrow therapeutic window. In transplant patients, drug pharmaco-kinetics will depend on the nature of the organ that’s been transplanted, the post-transplant time, drug therapy and the inherent pharmacokinetics of the immuno-suppressive drugs used. Very few pharmacokinetic studies of cyclosporine have been carried out in pediatric allo-HSCT patients. The goal of this study was to derive pharmacokinetic parameters of cyclosporine in pediatric allo-HSCT patients. Study populations were pediatric allo-HSCT patients in Seoul National University Hospital from Jan. 2002 to Sep. 2005 who took cyclosporine microemulsion capsules as an immunosuppressive drugs. Blood sampling was carried out before taking cyclosporine in the morning (C0). Drug concentrations are measured by Cyclotrac (monoclonal radioimmunoassay). Pharmacokinetic analysis was fitted by linear square method. Default data of the program were bioavailability 43%, Ka 0.7hr-1, Vd 4.3L/kg, and Kel 0.1hr-1. Either age or body weight correlate to CL/F and pearson correlation test was used as a statistic method for coefficients. Mean pharmacokinetic parameters of cyclosporine in study populations (n=16) were as follows Vd was 5.71±1.52 L/kg, Cmax was 717.15±194.10 ng/mL, Tmax was 2.65±0.38 hr, T1/2 was 7.13 ±2.53 hr and CL/F was 35.85±9.8 mL/min. Correlation coefficient between body weight and CL/F was -0.64, age and CL/F was -0.62. Cyclosporine showed considerable inter- and intraindividual variability. But CL/F varies inversely as body weight. Therefore specific pharmacokinetic parameters are applied to pediatrics. The lack of information concerning therapeutic ranges and drug interactions in the treatment of pediatric transplant recipients could be partially overcome by applying this population approach.
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KEYWORD
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Cyclosporine, pharmacokinetic parameter, pediatric, allo-HSCT
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