Neoral monitoring 2 hours post-dose and the pediatric transplant patient.

Cyclosporin A therapy has evolved greatly over the past 25 years of clinical experience. Sophisticated studies of CsA pharmacokinetics and pharmacodynamics have led to a better understanding of the relationship between dose response and biological effect. It has become apparent that achieving target drug exposure is necessary for optimal clinical outcomes. Monitoring dose response has become a key aspect of immunosuppressive management. This review presents the information available supporting cyclosporin drug concentration drawn two hours post dose (C-2) in children who have been transplanted as the best single indicator of CsA exposure. Further studies evaluating the clinical benefit of achieving C-2 targets in children are indicated.