Hi Doctor, I’m a Kidney Transplant recipient for 4 years. I take 100mg of neoral / day. My CYA C2 level for almost 2 years is ranging from 500 – 650 ng/mL. And my Creatinine level is 1.1 (stable) However, after my laboratory test 2 Months ago, the CYA C2 level decreased to just 315 ng/mL. So my doctor told me to increase my Neoral from 100mg/day into alternate level every other day( 100mg-125mg-100mg-125mg-100mg). I just want to ask if the adjustment is correct or the CYA C2 level of 350 ng/mL is still OK as long as the creatinine level is stable?

C2 cyclosporine levels (drug levels measured at two hours after your dose of cyclosporine) are not commonly performed any longer.  I do not rely on these levels to dose cyclosporine.  I use levels that are measured just prior to your next dose of cyclosporine (known as trough levels of cyclosporine).  Hence, I would follow your doctor’s advice if he or she has been determining these levels in the past.  The past experience is the best way to maintain your transplanted kidney for the long term.  You should ask your nephrologist to explain the dosing and then follow that advice.



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