Immunosuppressants: Dosage Insights for Autoimmune Treatment

Immunosuppressants

Hello, doctor.
I would like to ask if a 23-year-old female weighing 48 kg taking Myfortic 180 mg six times a day and Cyclosporine 100 mg twice a day is considered a high dosage? This is for the treatment of an autoimmune disease, and she is also using corticosteroids.
Thank you.

Pinggu, 20~29 year old female. Ask Date: 2013/04/01

Dr. Gao Jiankai reply Internal Medicine

Hello Apple, thank you for your question.
Regarding cyclosporine, the dosage will depend on the specific autoimmune disease and the associated health risks.
Generally, the use of this medication indicates that the condition requires active control of the immune system, and a common dosage is 5 mg per kilogram per day.
Therefore, based on your weight, you may need approximately 48 x 5 = 240 mg per day.
If your kidney function is good, this dosage should still be within an acceptable range.

As for Myfortic, one tablet's dosage is roughly equivalent to that of another similar medication, Cellcept (250 mg per tablet).
The typical dosage is usually quite high, often ranging from 6 to 10 tablets per day, with adjustments made gradually based on the condition.
However, the dosage calculation for adults does not have a direct relationship with body weight or body surface area.
For further dosage requirements, it would be best to discuss them with your physician for a more objective and ideal approach, applicable to both cyclosporine and Myfortic.
This is provided for your reference.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2013/04/01

More Info

When considering the use of immunosuppressants like Myfortic (mycophenolate mofetil) and cyclosporine for treating autoimmune diseases, it's essential to understand both the dosages and the context of their use. In your case, a 23-year-old female weighing 48 kg is taking Myfortic at a dosage of 180 mg six times a day and cyclosporine at 100 mg twice a day.

Myfortic (Mycophenolate Mofetil)
Myfortic is commonly used in autoimmune conditions and organ transplant patients to prevent rejection. The typical dosing for Myfortic in adults can vary widely based on the condition being treated, but it often ranges from 1,000 mg to 3,000 mg per day, divided into two doses. In your case, the total daily dosage of Myfortic is 1,080 mg (180 mg x 6), which falls within the acceptable range for many autoimmune treatments.

Cyclosporine
Cyclsporine is another immunosuppressant that is frequently used for autoimmune diseases and transplant patients. The dosing of cyclosporine is typically based on the patient's weight and the specific condition being treated. A common dosing guideline is approximately 5 mg/kg/day. For a patient weighing 48 kg, this would suggest a daily dose of around 240 mg. In your case, the total daily dosage of cyclosporine is 200 mg (100 mg x 2), which is lower than the typical range for many conditions but may still be appropriate depending on the clinical scenario and the physician's judgment.

Combination Therapy
The combination of Myfortic and cyclosporine is not uncommon in treating autoimmune diseases, as they work through different mechanisms to suppress the immune system. However, the use of corticosteroids alongside these medications can complicate the treatment regimen. Corticosteroids can help control inflammation but also come with their own set of side effects, especially when used long-term.

Monitoring and Adjustments
It's crucial to have regular follow-ups with your healthcare provider to monitor the effectiveness of the treatment and any potential side effects. Blood tests may be necessary to check kidney function, liver enzymes, and blood cell counts, as both Myfortic and cyclosporine can have significant side effects.

Conclusion
In summary, while the dosages you mentioned for Myfortic and cyclosporine may seem high, they are within the therapeutic range for many patients with autoimmune diseases. However, individual responses to these medications can vary significantly, and it is essential to work closely with your healthcare provider to ensure that the treatment plan is both safe and effective. If there are concerns about the dosages or side effects, discussing these with your doctor is the best course of action. They may consider adjusting the dosages or exploring alternative treatments based on your specific health needs and response to therapy.

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