At a Glance
Why Get Tested?
To determine the concentration of cyclosporine in your blood in order to establish a dosing regimen, maintain therapeutic levels, and detect toxic levels
When to Get Tested?
As soon as cyclosporine therapy begins, usually daily or 2-3 times a week, and periodically after that as the dose is adjusted or maintained
A blood sample drawn from a vein in your arm
Test Preparation Needed?
None. Typically drawn 12 hours after the last dose; on mornings when you are scheduled to have your cyclosporine level checked, do not take the medicine until after your blood is drawn.
The Test Sample
What is being tested?
Cyclosporine is an immunosuppressant drug used to reduce the body's natural defenses. This test measures the amount of cyclosporine in the blood.
When people undergo an organ transplant, their immune system recognizes the graft as "foreign" and will begin to attack it just as it would any invasive bacteria or virus. Cyclosporine diminishes the ability of certain white blood cells in the immune system to respond to this foreign tissue. The transplanted organ then has a better chance of survival and will not be as easily rejected by the transplant recipient's immune system. Cyclosporine is used routinely in the transplantation of kidney, heart, liver, and other organs.
The immunosuppressant qualities of cyclosporine have also been found to be useful in treating symptoms of some autoimmune and other disorders. These conditions are characterized by the immune system reacting to the body's own cells or tissue. Cyclosporine helps to control the immune response in these cases, decreasing the severity of symptoms. Some examples of these conditions include rheumatoid arthritis, psoriasis, aplastic anemia, and Crohn disease.
When the symptoms in these cases are judged to be severe, extensive, and disabling, cyclosporine may be prescribed. Usually, the symptoms have not diminished with other treatments or medications. Cyclosporine is used with caution in these cases and needs to be carefully monitored with blood tests.
Testing cyclosporine levels in the blood can help ensure that drug levels are in a range that will be therapeutic. If the level is too low, organ rejection may occur (in the case of transplantation) or symptoms may reappear (autoimmune cases). It is also important to ensure that the level is not too high and will not result in toxicity.
How is the sample collected for testing?
A blood sample is obtained by inserting a needle into a vein in the arm.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is needed. Samples are typically drawn 12 hours after the last dose. On mornings when someone is scheduled to have their cyclosporine level checked, the person should not take the medicine until after their blood is drawn.
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. McPherson R, Pincus M, eds. Philadelphia, PA: Saunders Elsevier: 2011, Pp 354-355.
Cyclosporine. University of Washington Medical Center. Available online at https://healthonline.washington.edu/document/health_online/pdf/Heart-Transplant-Cyclosporine.pdf through https://healthonline.washington.edu. Last reviewed October 2012. Accessed October 21, 2013.
Cyclosporine. Medline Plus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601207.html through http://www.nlm.nih.gov. Last updated September 1, 2010. Accessed October 21, 2013.
Cyclosporine. NYU Langone Medical Center. Available online at http://www.med.nyu.edu/content?ChunkIID=21718 through http://www.med.nyu.edu. Last reviewed August 2013. Accessed November 1, 2013.
Cyclosporine Clinic Guidelines for Monitoring Physicians. Vancouver Coastal Health. Avaialble online at http://www.arthritis.ca/document.doc?id=555 through http://www.arthritis.ca. Last reviewed April 2012. Accessed November 1, 2013.
(Updated Nov 17, 2011) Pelligrino B. Immunosuppression. Medscape Reference article. Available online at http://emedicine.medscape.com/article/432316-overview through http://emedicine.medscape.com. Accessed November 2013.
Sources Used in Previous Reviews
A Manual of Laboratory & Diagnostic Tests. 6th ed. Fischbach F, ed. Philadelphia: Lippincott Williams & Wilkins; 2000.
Clinical Chemistry: Principles, Procedures, and Correlations. Bishop M, Duben-Engelkirk J, Fody E, eds. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2000.
Clinical Diagnosis and Management by Laboratory Methods. 20th ed. Henry JB, ed. New York: Saunders: 2001.
Sacher RA, McPherson RA, Campos J. Widmann's Clinical Interpretation of Laboratory Tests. 11th ed. Philadelphia: F.A. Davis Company; 2000.
Karen L. Hardinger, Pharm.D. Matthew J. Koch, M.D.; Daniel C. Brennan, M.D., FACP (Posted 10/01/2004) Current and Future Immunosuppressive Strategies in Renal Transplantation, Medscape from Pharmacotherapy. Available online at http://www.medscape.com/viewarticle/489357 through http://www.medscape.com.
TOXNET, Toxicology Data Network (April 2006). Hazardous Substance Database. Division of Specialized Information Services (SIS) of the National Library of Medicine (NLM) (Online information-Search cyclosporine). Available online at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?HSDB through http://toxnet.nlm.nih.gov.
Medscape detailed monograph: Oral Cyclosporine (April 2006). Available online through http://www.medscape.com.
Michael R. Lucey; Manal F. Abdelmalek; Rosemarie Gagliardi; Darla Granger; Curtis Holt; Igal Kam; Goran Klintmalm; Alan Langnas; Kirti Shetty; Andreas Tzakis; E. Steve Woodle (2005). A Comparison of Tacrolimus and Cyclosporine in Liver Transplantation: Effects on Renal Function and Cardiovascular Risk Status. Medscape from American Journal of Transplantation 5(5):1111-1119. Available online at http://www.medscape.com/viewarticle/503095 through http://www.medscape.com.
Well, G (2005). Cyclosporine for treating rheumatoid arthritis. Cochrane Rev Abstract, The Cochrane Collaboration. Available online at http://www.medscape.com/viewarticle/485484 through http://www.medscape.com.
Naldi, L., Griffiths, CEM (2005). Traditional Therapies in the Management of Moderate to Severe Chronic Plaque Psoriasis: An Assessment of the Benefits and Risks. British Journal of Dermatology 152(4): 597-615. Available online at http://www.medscape.com/viewarticle/503441 through http://www.medscape.com.
(Revised 2009 December 1). Cyclosporine. MedlinePlus Drug Information [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601207.html. Accessed March 2010.
McMillin, G., and Wittwer, C. (Updated 2009 August). Organ Transplantation - Immunosuppressive Drugs. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/ImmunosuppressiveDrugs.html?client_ID=LTD through http://www.arupconsult.com. Accessed March 2010.
Pellegrino, B. and Schmidt, R. (Update 2009 October 14). Immunosuppression. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/432316-overview through http://emedicine.medscape.com. Accessed March 2010.
Malhotra, P. et. al. (Updated 2009 July 28). Immunology of Transplant Rejection. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/432209-overview through http://emedicine.medscape.com. Accessed March 2010.
(Updated 2010 March 1). Cyclosporine (Oral Route, Intravenous Route). MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/health/drug-information/DR601591 through http://www.mayoclinic.com/. Accessed March 2010.
Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 462.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1326-1329.