Affordable Access

Access to the full text

Neoral induction in pediatric renal transplantation

Authors
  • Bunchman, Timothy E.1
  • Parekh, Rulan S.1
  • Flynn, Joseph T.1
  • Smoyer, William E.1
  • Kershaw, David B.1
  • Valentini, Rudolph P.1
  • Pontillo, Brenda J.1
  • Sandvordenker, Jill1
  • Brown, Catherine1
  • Sedman, Aileen B.1
  • 1 Division of Pediatric Nephrology, University of Michigan, Michigan, USA, US
Type
Published Article
Journal
Pediatric Nephrology
Publisher
Springer-Verlag
Publication Date
Jan 01, 1998
Volume
12
Issue
1
Pages
2–5
Identifiers
DOI: 10.1007/s004670050390
Source
Springer Nature
Keywords
License
Yellow

Abstract

Neoral was instituted in pediatric renal transplant patients with the hypothesis it would have more predictable kinetics than Sandimmun. However, significant questions have arisen concerning potential toxicity and dosing interval related to its rapid absorption with subsequent high initial peak. This is compounded by the fact that children appear to metabolize cyclosporine at a greater rate than adults. This combination of a rapid peak and rapid absorption may then result in lower trough levels at 12 h. We compared the trough cyclosporine levels of nine children who received Neoral with nine who received Sandimmun at the time of initial transplantation. More frequent dosing (every 8 h) was required in the Neoral population compared with the Sandimmun population for the 1st month in order to obtain comparable trough levels. Beyond the initial 4–6 weeks, trough levels were similar for Neoral and Sandimmun. Whereas 1-month creatinine levels and blood pressures were similar, the number of blood pressure medications was significantly higher in the Neoral group. At 5.5 ± 1.1 months’ followup, a single patient in the current Neoral group and in the retrospective Sandimmun group each experienced a single OKT3 allograft-treated rejection. We suggest that the area under the curve is different in Neoral than Sandimmun, and the initial dosing frequency may need to be adjusted accordingly.

Report this publication

Statistics

Seen <100 times