ENHANCED ORAL CYCLOSPORINE ABSORPTION WITH WATER-SOLUBLE VITAMIN-E EARLY AFTER LIVER-TRANSPLANTATION

We evaluated the effect of Liqui-E, a water-soluble vitamin E preparat ion, on cyclosporin A (CBA) whole blood concentration in liver transpl ant recipients, and its impact on the cost of CyA. Patients were 26 li ver transplant recipients (19 adults, 7 children) who were unable to a chieve and maintain therapeutic CyA whole blood concentrations with th e standard recommended oral daily dose in the early post-transplant pe riod. Liqui-E 6.25 IU/kg orally was administered with CyA every 12 hou rs (median time of starting Liqui-E day 14.5). With Liqui-E, the daily oral CyA requirements (mean +/- SD) were decreased in adults from 22. 6 +/- 8.9 to 16.2 +/- 7.3 mg/kg/day (p<0.001) and in children from 78. 6 +/- 34.1 to 53.7 +/- 35.0 mg/kg/day (p<0.02); intravenous administra tion of CyA was unnecessary. The CyA trough concentrations (mean +/- S D) before and after Liqui-E were 670 +/- 186 and 1012 +/- 216 ng/ml, r espectively, in adults (p<0.001) and 732 +/- 187 and 1052 +/- 166 ng/m l, respectively, in children (p<0.01). When given with Liqui-E, the da ily cost of CyA decreased by 26% in both adults and children. No clini cal or biochemical evidence of Liqui-E toxicity was observed. Thus its administration in the early post-transplantation period can enhance C yA absorption in adults and children who are unable to achieve adequat e whole blood concentrations with the usual recommended oral dosages. In addition, a significant cost saving can be realized by coadministra tion.