Klin Farmakol Farm. 2010;24(2):93-97

Possibilities of cyclosporine A determination in therapeutic drug monitoring

Ilona Peřinová, Hana Brozmanová, Petra Halvová, Milan Grundmann

Ústav klinické farmakologie FN Ostrava a Fakulty zdravotnických studií Ostravské univerzity, Ostrava

Cyclosporine A (CyA) is a drug with narrow therapeutic range and high interindividual variability. No immunologic tests are known to

verify immunosuppressive effect of cyclosporine in clinical practice and that’s why CyA monitoring is limited mainly to determine its

concentration in blood. Immunoanalytic methods, high performance liquid chromatography (HPLC) and liquid chromatography-mass

spectrometry (LC-MS or LC-MS/MS) are regularly used to determine CyA concentration in therapeutic drug monitoring (TDM). Immunoanalytic

methods can analyze a lot of samples in short time and they are easy practicability, but the disadvantage is crossed reactions

with CyA metabolites. HPLC methods are considered to be referential for CyA determination, but they require time-consuming extraction

procedures important for successful separation. The analysis may take even tens of minutes. HPLC methods are also used to determine CyA

together with its metabolites. LC-MS and LC-MS/MS methods are selective, very sensitive and specific. The advantage of these methods

especially in the case of LC-MS/MS is high sample throughput and the possibility to determine CyA simultaneously with its metabolites

or other immunosuppressives in one analysis. On the other hand the initial instrumentation cost and a requirements of skilful staff are

limitations of these methods.

Keywords: cyclosporine A, TDM, imunoanalytic methods, HPLC-UV, LC-MS, LC-MS/MS

Published: July 1, 2010  Show citation