Benefits of pre-emptive dose reduction for Sandimmune to Neoral conversionin stable renal transplant recipients

In an effort to minimize nephrotoxicity resulting from greater exposure to cyclosporine after Sandimmune to Neoral conversion, we compared two convers ion regimens using different dosing ratios. Serial serum creatinine concent rations and trough cyclosporine levels were measured in 26 patients convert ed from Sandimmune to Neoral using a 1:0.8 dosing ratio (Group 1) and compa red to those of 26 patients converted using a 1:1 dosing ratio (Group 2). T he percentage change in peak serum creatinine concentration after conversio n was greater in Group 2. However, at last follow-up, the dose reductions i n each group were comparable. Following conversion, patients in Group 1 req uired fewer dose adjustments and follow-up blood tests. Compared to convers ion using a 1:1 dosing ratio, conversion from Sandimmune to Neoral using a 1:0.8 ratio results in comparable dose reductions and less short-term nephr otoxicity, while requiring less frequent laboratory monitoring.