Comparative Pharmacology
Head-to-head clinical analysis: ASTAGRAF XL versus CYCLOSPORINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ASTAGRAF XL versus CYCLOSPORINE.
ASTAGRAF XL vs CYCLOSPORINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Calcineurin inhibitor that binds to FKBP-12, forming a complex that inhibits calcineurin, thereby preventing dephosphorylation and nuclear translocation of NFAT, which reduces T-cell activation and cytokine production (e.g., IL-2).
Cyclosporine is a calcineurin inhibitor that binds to cyclophilin, forming a complex that inhibits calcineurin, thereby preventing dephosphorylation and nuclear translocation of nuclear factor of activated T-cells (NFAT), which reduces transcription of interleukin-2 and other cytokines, leading to immunosuppression.
Initial oral dose of 0.1-0.15 mg/kg/day divided every 12 hours, with subsequent adjustments based on trough levels. Typical maintenance dose 0.05-0.15 mg/kg/day.
Initial oral dose: 3-5 mg/kg/day divided q12h; maintenance: 2-4 mg/kg/day divided q12h. IV dose: 3-5 mg/kg/day as continuous infusion or divided q8-12h.
None Documented
None Documented
Clinical Note
moderateCyclosporine + Norfloxacin
"The metabolism of Norfloxacin can be decreased when combined with Cyclosporine."
Clinical Note
moderateCyclosporine + Torasemide
"The risk or severity of adverse effects can be increased when Cyclosporine is combined with Torasemide."
Clinical Note
moderateCyclosporine + Etacrynic acid
"The risk or severity of adverse effects can be increased when Cyclosporine is combined with Etacrynic acid."
Clinical Note
moderateCyclosporine + Furosemide
Terminal elimination half-life is approximately 43 hours (range 15.8–68.6 hours) in adult kidney transplant recipients. This long half-life supports once-daily dosing. In liver transplant patients, half-life ranges from 12 to 42 hours.
Terminal elimination half-life ranges from 8.4 to 27 hours (mean ~19 hours) in adults with normal liver function. In patients with hepatic impairment, half-life may be prolonged. Pediatric patients typically have shorter half-lives (7–19 hours).
Primarily fecal (94.6%) via biliary elimination. Renal excretion accounts for approximately 2.4% of the dose, mainly as metabolites. Less than 1% is excreted unchanged in urine.
Primarily hepatic metabolism via CYP3A4; eliminated in bile and feces. Renal excretion accounts for <6% of unchanged drug. Approximately 90% of metabolites are excreted in bile and feces.
Category C
Category D/X
Immunosuppressant, Calcineurin Inhibitor
Immunosuppressant
"The risk or severity of adverse effects can be increased when Cyclosporine is combined with Furosemide."