Cyclosporine, which is not unfamiliar to many patients with autoimmune diseases such as transplantation or aplastic anemia, can be regarded as one of the cornerstones and standard drugs of immunosuppressive therapy. Cyclosporine was first discovered to come from a beautiful and desolate "barren land".
In 1970, a traveler came to a norwegian plateau for a holiday, the endless ground is full of all kinds of stones, this traveler is a pharmaceutical factory microbiology researcher, he took a small bag of local soil out of professional habits, did not expect that this bag of soil has a filamentous fungal strain, will secrete a compound, that is, cyclosporine. At that time, most of the immunosuppressants on the market, such as azathioprine, cyclophosphamide, etc., due to large side effects, many transplant patients had to suffer serious drug side effects if they needed to prevent rejection, and the survival rate was not high. The discovery of cyclosporine has greatly improved the survival rate of transplantation, which is known as the cyclosporine era. In the process of taking cyclosporine, there are also some precautions.
How to take cyclosporine correctly?
The time of use should be fixed. Since the window of cyclosporine treatment is relatively narrow, in order to achieve a stable drug concentration, it is best to take it at a fixed time, and pay attention to the time of diet. Because cyclosporine is a fat-soluble drug, oral absorption is slow and susceptible to some foods, so the time of taking drugs and diet should be fixed, so as not to affect the drug concentration due to changes in meal time.
The method of administration has a doorway. In general, the drug is taken with boiled water, but sometimes the doctor may recommend taking it with milk, because cyclosporine is fat-soluble and taking it with milk can promote its absorption. The concentration is not as high as possible, and the appropriate mode of administration needs to be selected under the evaluation of a professional doctor.
Drug concentrations are checked regularly. Cyclosporine has a characteristic, individual differences are large, drug concentrations in different human bodies vary greatly, and the treatment window is relatively narrow, so it is necessary to adjust the appropriate drug dose with the help of drug concentration monitoring.
Diet and medication should be paid attention to. The concentration of cyclosporine will be affected by some foods, such as grapefruit juice can reduce its concentration and weaken the effect, while milk, other juices, etc. will increase its absorption and increase the concentration. There are also some drugs that also have an effect on cyclosporine concentrations, such as ibuprofen, gentamicin, isoniazid, etc. will increase cyclosporine toxicity.
epilogue
Cyclosporine has brought healthy lives to more than 500,000 transplant patients, and with the improvement of medical technology, it is believed that more and more drugs can be explored and screened out.
author:
Liu Longzhen, deputy director of the Department of Pharmacy, Second Hospital of Zhuzhou City, Hunan Province
bibliography:
1. Wang Yan,Ji Huaixue. Precautions for monitoring blood drug concentration of cyclosporine A and guidance on medication[J].Journal of Rational Clinical Use,2012,32:171-172.
2.Yin Yuqin,Liu Yong,Xu Guili,Zhang Yunling. Effect of drug interaction on blood concentration of cyclosporine A[J].Chinese Pharmaceutical Affairs,2006,06:378-379+381.