EXAMINATION OF ADMINISTRATIVE DOSAGE OF CYCLOSPORINE DURING THE ANTI-TUBERCULOSIS CHEMOTHERAPY INCLUDING RIFAMPICIN

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  • MATSUI Yoshinori
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital Depai tHient of Pulmonary Medicine, Jikei University School of Medicine
  • AKAGAWA Shinobu
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • KAWASHIMA Masahiro
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • SUZUKI Junko
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • MASUDA Kimihiko
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • TAMURA Atsuhisa
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • NAGAI Hideaki
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • NAGAYAMA Naohiro
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • KAWABE Yoshiko
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • MACHIDA Kazuko
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • KURASHIMA Atsuyuki
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital
  • YOTSUMOTO Hideki
    Department of Pulmonary Medicine, National Hospital Organization Tokyo National Hospital

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Other Title
  • リファンピシンを含む結核治療におけるシクロスポリン投与量の検討
  • リファンピシン オ フクム ケッカク チリョウ ニ オケル シクロスポリン トウヨリョウ ノ ケントウ

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Abstract

[Aims] In the treatment of tuberculosis with rifampicin in patients treated with prednisolone and cyclos porine, we have to increase the dosage of these drugs. Although prednisolone dosage is recommended to be doubled, there is no established consensus about cyclosporine dosage. Our aim is to review the current situation at our institution regarding the dosage of cyclosporine administered to tuberculous patients after the addition of rifampicin to the treatment regimen.<BR>[Methods and Results] We reviewed patients' clinical status and how dosages of cyclosporine were altered during a course of tuberculosis treatment including rifampicin in 4 patients (2interstitial pneumonitis, 2 collagen vascular disease) who were being treated with cyclosporine between 2001 and 2003. Prednisolone had been also administrated in all patients and the dosage was doubled from the beginning of the treatment. The appropriate dosage of cyclosporine was found to be 2.53.5 (average 3) times that of initial dosage, and it required 512 weeks (average 8.3) measurements of trough levels and 6-27 (average 12) weeks until appropriate trough levels were obtained.<BR>[Conclusions] The appropriate dosage of cyclosporine was found to be approximately 3 times that of the initial dosage in all patients, but it required a long term and frequent measurements of trough levels before reaching this goal. It seems that trebling the dosage of cyclosporine from the start of anti-tuberculosis chemotherapy will be an efficient way to achieve good clinical outcome.

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