Cyclosporine hyperlipidemia with

A multicenter randomized comparative trial of tacrolimus in combination with azathioprine or mycofenolate mofetU (MMF) versus cyclosporin (microemulsion) with MMF after cadaveric kidney transplantation demonstrated that all regimens yielded similar acute rejection and graft survival rates at 1 year. The tacrolimus-MMF regimen was associated with the lowest rate of steroid-resistant rejection requiring antilymphocyte therapy. In addition, the tacrolimus-treated patients had lower incidence of hyperlipidemia, a side effect of particular concern in these patients [60]. 

Tacrolimus has shown the propensity to cause less severe hyperlipidemia when compared with cyclosporine. Thus conversion from cyclosporine-based immunosuppression to tacrolimus-based immunosuppression may be one way to counteract this disease in transplant recipients.66 Studies demonstrate that steroid withdrawal in renal transplant patients lowered total cholesterol by 17% and LDL-C by 16% unfortunately, an 18% decrease in high-density lipoprotein (HDL) levels also was noted in these patients.66... 

Compared with previously available therapy, the adverse effects associated with cyclosporine are much less severe but still worthy of concern. Nephrotoxicity, which can occur in up to 75% of patients, ranges from severe tubular necrosis to chronic interstitial nephropathy. This effect is generally reversible with dosage reduction. Vasoconstriction appears to be an important aspect of cyclosporine-induced nephrotoxicity. Hypertension occurs in 25% of the patients and more frequently in patients with some degree of renal dysfunction the concomitant use of antihypertensive drugs may prove useful. Hyperglycemia, hyperlipidemia, transient liver dysfunction, and unwanted hair growth are also observed. 

Taylor DO, Barr ML, Radovancevic B, Renlund DG, Mentzer RM Jr, Smart FW, Tolman DE, Frazier OH, Young JB, VanVeldhuisen P. A randomized, multicenter comparison of tacrohmus and cyclosporine immunosuppressive regimens in cardiac transplantation decreased hyperlipidemia and hypertension with tacrohmus. J Heart Lung Transplant 1999 18(4) 336-45. 

Cyclosporine inhibits the metabolism of Ever, requiring Ever dose reduction when co-administered with CyA simultaneous administration of CyA and Ever is expected to be the usual approach to immunosuppression. Ever does not affect CyA metabolism. The primary side effect of concern with Ever therapy is hyperlipidemia. ... 

P. A randomized, multicenter comparison of tacrolimus and cyclosporine immunosuppressive regimens in cardiac transplantation decreased hyperlipidemia and hypertension with tacrolimus. J Heart Lung Transplant 1999 18 336-345. 

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