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Correlation between Cyclosporine Blood Levels and Area under Blood Concentration Time Curve in Iraqi Bone Marrow Transplant Patients Treated with Neoral® Oral Solution

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Baghdad Teaching Hospital, Medical City, Ministry of Health, Baghdad 10069, Iraq
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TDM Center, Baghdad Teaching Hospital, Medical City, Ministry of Health, Baghdad 10069, Iraq
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Department of Pharmacy, Al-Rasheed University College, Ministry of Higher Education and Scientific Research, Baghdad 10069, Iraq
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Pharmacy College, Al-Farahidi University, Ministry of Higher Education and Scientific Research, Baghdad 10069, Iraq
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Author to whom correspondence should be addressed.
Sci. Pharm. 2020, 88(1), 12; https://doi.org/10.3390/scipharm88010012 (registering DOI)
Received: 27 January 2020 / Revised: 4 March 2020 / Accepted: 5 March 2020 / Published: 11 March 2020
Cyclosporine is a potent immunosuppressive drug. It has a narrow therapeutic index, and therefore the measurement of cyclosporine’s blood concentration is essential to obtain optimal therapy. Measurement of the area under the blood concentration-time curve (AUC) is reflective of total drug exposure. However, for organ transplant patients, the measurement of AUC involves many problems and difficulties. Thus, it is more clinically acceptable to use a single blood sample as a surrogate index of total drug exposure. Fifty-four adults bone marrow transplant Iraqi patients were given cyclosporine every 12 h as prophylaxis using Neoral® oral solution. Steady-state blood concentrations were monitored for each patient at zero time and then at 1, 2, 3, 4, 6, 8, 10, and at 12 h post-dosing. Cyclosporine blood levels were determined by using AXSYM automated immuno-analyzer which is a fluorescence polarization immunoassay (FPIA). The present investigation demonstrated the best correlation between C2 and the corresponding AUC0–4h and AUC0–12h compared to other concentrations. After two months of cyclosporine therapy, no unexpected biochemical changes and adverse effects were registered. It is concluded from this study that a single blood sample obtained at 2 h post-dosing (C2) and possibly at 3 h post dosing (C3) are ideal surrogate indexes for reflecting total drug exposure, and therefore may be used in clinical practice for predicting therapeutic and toxic effects of cyclosporine. View Full-Text
Keywords: bone marrow transplant Iraqi patients; cyclosporine blood concentrations; AUC; biochemical changes; adverse effects bone marrow transplant Iraqi patients; cyclosporine blood concentrations; AUC; biochemical changes; adverse effects
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Abass, H.M.; Al-Tamimi, K.F.; Al-Tamimi, D.J.; Ibraheem, J.J. Correlation between Cyclosporine Blood Levels and Area under Blood Concentration Time Curve in Iraqi Bone Marrow Transplant Patients Treated with Neoral® Oral Solution. Sci. Pharm. 2020, 88, 12.

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