448 Section 13/ Miscellaneoushelper T-cells. At molecular level it affects
cyclophilin proteins.
After oral administration it is absorbed
and is highly concentrated in erythrocytes.
After metabolism in liver most of the drug is
excreted in bile. Some metabolites are active
and show immunosuppressive activity.
Adverse effects include nephrotoxicity,
hypertension, tremor, seizures, increased
incidence of infections, gingival hyperpla-
sia, hirsutism, flushing, paraesthesias, tin-
nitus, headache, gynaecomastia and con-
junctivitis. It has no toxic effects on bone
marrow and RE system.
It is used to prevent graft rejection after
kidney, liver, heart, lung, pancreas transplant
or bone marrow transplantation and psoria-
sis not responding to conventional therapy.
Dosage:
Solid organ transplantation: Oral dose
should be initiated within 12 hours before
surgery at a dose of 10 to 15 mg/kg in two
divided doses, then continued for one to
two weeks postoperatively followed by
maintenance dose of 2 to 6 mg/kg.
Bone marrow transplantation: Start a
day before transplantation. IV infusion:
3 to 5 mg/kg/day, continue two weeks
postoperatively, then continue with oral
preparation in dose of 12.5 mg/kg in
two divided doses for six months to one
year.
Psoriasis: Initial 2.5 mg/kg/day orally
in two divided doses. Maximum dose is 5
mg/kg/day.