Safe conversion to cicloral, a generic cylosporine, in both stable and de novo renal transplant recipients

Abstract

Several generic cyclosporine (CsA) formulations have been developed over the last decade and are now widely available. In 2003 our local Health Department replaced Neoral with CicloHexal for the cost benefits, and we were compelled to convert all our renal transplant recipients to the generic CsA formulation. All renal transplant recipients were converted from Neoral to CicloHexal on a 1:1 dose basis in August/September 2003. Study 1 constitutes the retrospective review of all stable renal transplant patients and the CsA dose, CsA level and serum creatinine were noted. Study 2 constitutes the review of the records of de novo transplant patients inititated on CicloHexal compared to matched patients transplanted on Neoral before the conversion and the CsA dose, CsA level and serum creatinine noted (Study 2). There was no difference in the mean CsA dose, CsA level or serum creatinine at one month before conversion (on Neoral) compared to one month after conversion (on CicloHexal) in the 117 stable renal transplant recipients. Similarly, the mean CsA dose, CsA level and serum creatinine in de novo renal transplant recipients on Neoral (n=26) were similar to those on CicloHexal (n=23) at about seven and ten days postoperatively. In conclusion both stable and de novo renal transplant patients can be safely converted from Neoral to CicloHexal on a 1:1 dose basis.