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Indications for use Rapamune 1mg
Prevention of transplant rejection (in case of adult patients with low and moderate immunological risk after kidney transplantation in combination with GCS and cyclosporine);
Rapamune 1mg contraindications
Hypersensitivity, pregnancy, lactation, childhood and adolescence
Method of reception and doses of Rapamune 1mg
It is recommended to take the drug in combination with cyclosporine and corticosteroids for 2-3 months. If it is necessary, the therapy can be continued in combination with GCS without cyclosporine. Initial therapy (within 2-3 months after transplantation): the usual mode implies the reception of a single dose of 6 mg within 48 hours after transplantation, followed by a maintenance dose of 2 mg/day. In the future, the dose should be selected so that the level of Cmin in the blood is within 4-12 ng/ml (chromato graphic method). The level of Cmin cyclosporine in the blood during the first 2-3 months after transplantation should be maintained at 150-400 ng/ml (monoclinic method of concentration determination).
Cyclosporine should be abolished within 4-8 weeks and the dose of Rapamune 1mg should be chosen depending on its concentration in the blood. It is recommended to maintain Cmin in blood at the level of 12-20 ng/ml (chromato graphic method). Patients whose cyclosporine withdrawal attempt was unsuccessful (cannot be performed), shouldn’t take cyclosporine in combination with Rapamune 1mg for more than 3 months after transplantation. If you one of such patients, then the drug should be abolished and an alternative mode of immunosuppression should be prescribed. The dose adjustment is not required for elderly patients, as well as patients with CPN and hepatic insufficiency of mild and moderate severity.
The therapy should be carried out under the supervision of a doctor with relevant experience in Transplantology. It is intended only for oral reception. There is experience of reception of Rapamune 1mg at the same time with cyclosporine, azathioprine, mycophenolate mofetil, corticosteroids and cytotoxic antibodies. The use in combination with other immunosuppressive drugs has not been studied enough, and the use of Rapamune 1mg in patients with high immunological risk of transplant loss has also been poorly studied. The available data are insufficient to recommend the use of the drug to children and adolescents.