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KMID : 0869620080250030228
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Journal of Korean Society of Hospital Pharmacists
2008 Volume.25 No. 3 p.228 ~ p.232
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Dosage determination in changing from intravenous cyclosporine to oral formulation in hematopoietic cell transplantation
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Koo Hyeon-Jeoung
Ryu Seong-Gil
Han Hye-Won
Kim Jae-Youn
Song Yung-Cheon
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Abstract
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Few studies have been done on the pharmacokinetics of Cyclosporin A(CsA) in Korean hematopoietic cell transplantation(HCT) patients. The aim of this study is to determine CsA oral dose when changed from intravenous(i.v.) formulation in HCT patients. This study was performed in retrospective and non-randomized study design. HCT and oral CsA dose adjustment underwent patients who received CsA were enrolled and patients whose CsA dose adjustments were done over 14 days from HCT date were excluded. Patients’demographic data and medication information of CsA administration were collected from electronic medical record(EMR). Total 102 patients were studied. The first ratio that changed from i.v. form to oral formulation was 2.08 ± 0.48(mean±SD). After achieving steady state with capsule form, dose adjustment was done secondly and the ratio from iv form to second oral form was 1.59 ± 0.45(mean±SD). This ratio(PO ratio_2) was considered optimal dose changing ratio from i.v. to p.o. formulation in HCT patients. A disproportionate relationship between the lengths of i.v. CsA administration and PO ratio_2 could be found(r2=0.061, p=0.012). Final i.v. dose(mg/kg) and PO ratio_2 was also inversely proportional(r2=0.083, p=0.003). It is rational to use dose ratio of around 1:1.5 or 1:1.6 when an HCT patient convert their i.v. CsA to p.o CsA, considering length of i.v. CsA use and final i.v. dose/kg of patient
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KEYWORD
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Cyclosporin A, CsA dose ratio, CsA dosage form change, length of i.v.CsA use
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