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Therapeutic monitoring of calcineurin inhibitors for the nephrologist Schiff J; Cole E; Cantarovich MClin J Am Soc Nephrol 2007[Mar]; 2 (2): 374-84The calcineurin inhibitors (CNI) cyclosporine and tacrolimus remain the backbone of immunosuppression for most kidney transplant recipients. Despite many years of experience, protocols that optimize efficacy with minimal toxicity remain a subject of debate. Nevertheless, studies of the pharmacokinetic properties of the CNI, particularly cyclosporine, have led to improved dosing strategies. The purpose of this article is to review the current understanding of CNI pharmacokinetics and its relevance to proper dosing and monitoring of these medications. This article also reviews the trials that have helped to define the optimal dosages and discusses the effect of adjunctive immunosuppressive agents on CNI pharmacokinetics and dosing.|*Calcineurin Inhibitors[MESH]|*Kidney Transplantation[MESH]|Cyclosporine/blood/*therapeutic use[MESH]|Drug Monitoring[MESH]|Humans[MESH]|Immunosuppressive Agents/blood/*therapeutic use[MESH]|Nephrology[MESH]|Tacrolimus/blood/*therapeutic use[MESH] |
