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[Often referred to by brand name (see MedlinePlus Drug Information)]
Nome formal
Cyclosporine
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Este artigo foi modificado pela última vez em
11 de Maio de 2018.
At a Glance
Why Get Tested?
To determine the concentration of cyclosporine in your blood in order to establish a dosing regimen, maintain therapeutic levels, and detect toxic levels
When To Get Tested?
As soon as cyclosporine therapy begins, usually daily or 2-3 times a week, and periodically after that as dose is adjusted or maintained
Sample Required?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
None
What is being tested?
This test measures the amount of cyclosporine in the blood. Cyclosporine is an immunosuppressive drug used to dampen the body’s natural defenses. When patients undergo an organ transplant, their immune system recognizes the graft as a foreign substance and will begin to attack it just as it would any invasive bacteria or virus. Cyclosporine affects the ability of certain white blood cells in the immune system to respond to this foreign tissue. The transplanted organ then has a better chance of survival and will not be as easily rejected by the patient’s system. Cyclosporine is used routinely in the transplantation of kidney, heart, liver, and other organs.

The immunosuppressive qualities of cyclosporine have also been found to be useful in treating symptoms of some autoimmune and other disorders. These conditions are characterized by the immune system reacting to the body’s own cells or tissue. Cyclosporine helps to control the immune response in these cases, decreasing the severity of symptoms. Some examples include rheumatoid arthritis, psoriasis, aplastic anemia, and Crohn’s disease.

When the symptoms in these cases are judged to be severe, extensive, and disabling, cyclosporine may be prescribed. Usually, the symptoms have not responded well to other treatments or medications. Cyclosporine is used with caution in these cases and needs to be carefully monitored with blood tests.

Testing cyclosporine levels in the blood can help ensure that drug levels are in a range that will be therapeutic for you. If the level is too low, organ rejection may occur (in the case of transplantation) or symptoms may reappear (autoimmune cases). It is also important to ensure levels are not too high and will not result in toxicity.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.
Accordion Title
Common Questions
  • How is it used?
    The test for cyclosporine is ordered to measure the amount of drug in the blood to determine whether drug concentrations have reached therapeutic levels and are not in a toxic range. It is important to monitor levels of cyclosporine for several reasons:

  • There is not a good correlation, as with some other medications, between the dose of cyclosporine given and level of drug in the blood.
  • Absorption and metabolism of oral doses of cyclosporine can vary greatly between patients and even in the same patient depending on the time of dose and what food is eaten.
  • There can be variation in blood levels due to the brand or preparation of cyclosporine prescribed.
  • In transplant patients, it is particularly important for graft survival to ensure that cyclosporine levels are high enough immediately following surgery to prevent rejection of the transplanted organ.
  • Blood levels need to be high enough in the case of rheumatoid arthritis or psoriasis to begin to give relief of symptoms.
  • In the case of kidney transplantation, blood levels may help to distinguish between kidney rejection and kidney damage due to high levels of cyclosporine.
  • Cyclosporine is associated with several toxic side effects that can be avoided if blood levels are monitored and the dose adjusted if the level detected is too high.
  • By monitoring cyclosporine blood levels, doctors can better ensure that each individual is receiving the right amount and formulation of drug needed to treat their particular case.

  • When is it ordered?
    Cyclosporine is ordered frequently at the start of therapy, often on a daily basis when trying to establish a dosing regimen. Once an appropriate dose has been determined, the level can be tested less frequently and may eventually be tested once every 1-2 months.

    Often in transplantation, patients will begin with higher doses of cyclosporine at the start of therapy and then decrease the dose over the course of long-term therapy. In the cases of rheumatoid arthritis or psoriasis, if a patient appears to tolerate the drug well, the dose may be increased to further improve symptoms. With each change in dose, blood levels need to be measured. In addition, the frequency of testing depends on a number of factors including type of organ transplanted, age, and general health status of the patient. For example, a patient with a transplanted liver may need to be monitored more regularly since cyclosporine is metabolized mainly by the liver, and impaired function can slow clearance of cyclosporine from the blood. Tests may also be ordered more often when organ rejection or kidney toxicity is suspected.

  • What does the test result mean?
    The therapeutic range for cyclosporine depends on both the method used to measure the drug and the type of transplant. Results obtained from different types of samples and different methods are not interchangeable. Your doctor will be guided by the laboratory that does the testing as to the appropriate therapeutic range to apply to your test result.

    A majority of institutions use whole blood samples instead of serum or plasma and will collect samples 12 hours after the last dose or just before the next dose (trough levels). Some laboratory methods are more specific for the cyclosporine parent drug while others measure the parent drug plus the metabolites so their respective ranges will differ.

    If trough levels fall below the desired range, there is a risk of transplant rejection or symptom recurrence. If levels detected are above the range, there is a risk of toxic side effects.

    Some signs or symptoms of cyclosporine toxicity are:

  • kidney damage
  • high blood pressure
  • tremors
  • bleeding, swelling, overgrowth of gums li>
  • hirsutism
  • hyperlipidemia
  • Peak concentrations of samples collected 2 hours post dose are sometimes tested in transplant cases. High levels of cyclosporine in peak samples are correlated with reduced rejection rates, especially in the first year after transplant surgery.