High pressure liquid chromatographic determination of cyclosporin-A in human plasma

Periodic monitoring of plasma drug concentrations has been suggested as a means whereby the toxicity of Cyclosporin A (CyA) can be reduced in patients undergoing bone marrow transplantation. We have developed a sensitive and specific method for the determination of CyA in plasma using reverse phase high pressure liquid chromatography (HPLC). Cyclosporin D was used as the internal standard. The lower limits of detection are 100 ng/ml in biological fluids and 20 ng per injection onto the column. We have analyzed plasma samples from patients who received CyA at doses which ranged from 8 to 15 mg/kg/day. Although all patients experienced toxic or therapeutic effects, plasma concentrations of CyA were consistently less than 100 ng/ml when analyzed by this method. We conclude that analytical methods currently available for the detection of CyA are unsuitable for the monitoring of patients who receive this agent.