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Is recommended that regular monitoring of therapeutic everolimus concentration in whole blood. It was found that patients  frequency biopsy confirmed acute rejection as the kidneys and the heart on the basis of the analysis of exposure-efficacy and exposure-safety, it was lower than in patientsl. The recommended upper limit of everolimus therapeutic concentration range is 8 ng / mL. Concentrations  not been studied. Everolimus concentrations were determined by chromatography.

Everolimus particularly important to control the concentration in the blood of patients with liver failure during simultaneous use of strong buy parabolan inducers and inhibitors, when switching to a different dosage form and / or the dose of cyclosporin is significantly lowered. Everolimus blood concentrations when applied dispersible tablets may be somewhat lower than with conventional tablets. It is preferred to carry out the correction of dosing regimen Sertikana based on the values  of everolimus, determined more than 4-5 days after the previous dose change. Since cyclosporin is reacted with everolimus may decrease the concentration of the latter, if the concentration of cyclosporin is significantly reduced (P 0 <50 ng / ml).

Recommendations for the dosage regimen of cyclosporine in combination therapy with sertikanom in patients after kidney transplantation
Sertikan should not be used for a long time with cyclosporine the full dose. Reducing the dose of cyclosporine in renal transplantation patients after receiving Sertikan led to improvement in renal function.Reduced doses of cyclosporine should be started after 1 month post-transplantation.

It is important that in the early period after transplantation concentration of everolimus and cyclosporine is not decreased below the therapeutic range, with a view to minimizing the risk of lack of efficacy.

Prior to dose reduction of ciclosporin it should be ascertained that the equilibrium value of C 0 of everolimus is> 3 ng / ml.

There is limited information regarding dosing at concentrations of cyclosporine <350 ng / ml in the maintenance phase. If the patient can not tolerate reduction of the dose of cyclosporine, it is necessary to revise the subsequent use buy parabolan.

Recommendations for dosing regimen of cyclosporin in combination therapy with sertikanom patients after heart transplantation
for patients after cardiac transplantation in the maintenance phase dose of cyclosporine must be reduced in order to improve kidney function. With the progression of renal dysfunction or if the calculated value is creatinine clearance <60 mL / min, the treatment regimen requires a correction on the basis of the data obtained in clinical studies. In studies Sertikan administered in combination with reduced doses of cyclosporine and the value of the basal concentration (C 0 ) consisted of cyclosporine (ng / ml): 1 month – 200-350; Month 2 – 150-250, 3-4 month – 100-200; 5-6 month – 75-150; month 7-12 – 50-100.

Prior to dose reduction of ciclosporin it should be ascertained that the equilibrium value of C 0 of everolimus is> 3 ng / ml.

If there are limited data regarding dosing heart transplant Sertikana at C 0 cyclosporine 50-100 ng / ml – after 12 months.

Instructions for use of the drug in the form of tablets
Tablets should be taken whole, not to break up prior to use; drink a glass of water.

Instructions for use of the drug in the form of dispersible tablets
patients who can not swallow tablets, dispersible  prescribed, of which the dispersion is prepared in tablet form (fine solid particles in water).

Reception by oral syringe 10 ml
Place the syringe into dispersible tablets. Max buy parabolan from which one can prepare a dispersion having a volume of 10 ml of water (10 ml syringe), is 1.25 mg. Add water to the level of 5 ml. Wait 90 seconds while lightly shaking the syringe. After the formation of the dispersion type the contents of the syringe directly into the mouth. Rinse the syringe, gaining 5 ml of water, and enter the contents into the mouth. This is followed by 10-100 ml of water to drink. steroiden kaufen

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