Causes of variability in oral cyclosporine administration

J. K. Whipple, R. K. Ausman, M. B. Adams, S. D. Weitman, R. Thomson, E. J. Quebbeman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Patient compliance with a regimen of cyclosporine capsules often is a problem in the pediatric population because the capsules are too large to ingest. Some adults have the same difficulty. Such patients are given oral solutions. A clinical observation and a laboratory simulation were used to determine if oral solutions are completely and consistently ingested by the patient. Drinking glasses used by 13 patients were obtained after the prescribed dose had been administered. In addition, during a laboratory simulation, 24 glasses containing cyclosporine were divided into eight groups: those containing stirred and unstirred chocolate milk and orange juice at temperatures of 5° and 20° Celsius. Each group was sampled at 1, 15, and 30 minutes after mixing of the solution. The amount of cyclosporine remaining in the patients' glasses was 2 to 31 mg (0.5% to 18.2% of the dose). The laboratory simulation revealed a loss of between 3 and 54 mg (1% to 18% of the dose). The authors conclude that a variable amount of cyclosporine remains in the drinking glass used to dispense the dose. As a result, patients receive incomplete doses, which may contribute to the variability of cyclosporine serum concentrations. For patients who are unable to ingest cyclosporine capsules, an alternative method of administering cyclosporine is needed.

Original languageEnglish (US)
Pages (from-to)761+764+783
JournalHospital Pharmacy
Issue number9
StatePublished - Jan 1 1992
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacy
  • Pharmacology
  • Pharmacology (medical)


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