Drug | Drug monitoring* | Target level¶ |
Tacrolimus | Immediate-release tacrolimus: whole-blood 12-hour trough (C0) levels Extended-release tacrolimus: whole-blood 24-hour trough (C0) levels | Target C0 levels:
|
Cyclosporine | Whole-blood 12-hour trough (C0) levels or two-hour postdose (C2) levelsΔ | Target C0 levels:
Target C2 levels:
|
Sirolimus | Whole-blood trough levels, drawn one hour prior to the next oral dose | 4 to 6 ng/mL |
Everolimus | Whole-blood trough levels, drawn one hour prior to the next oral dose | 5 to 7 ng/mL |
* The frequency of drug monitoring varies depending upon the time posttransplant and transplant center protocol.
¶ Target levels may vary from center to center.
Δ Although monitoring of trough levels (12 hours postdose) of cyclosporine is common practice, there is a poor correlation between clinical outcome and drug exposure as assessed using this strategy. Thus, in some patients (eg, patients suspected of having poor cyclosporine absorption), 2-hour postdose cyclosporine levels are monitored. Among kidney transplant recipients, the C2 level may correlate more closely with exposure, with higher C2 concentrations being associated with decreased acute rejection rates in the first year posttransplant. However, C2 monitoring is often more difficult and less convenient for the patient.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟