[Joseph Z.]

Hello,

I'm 12 days post-hospital treatment of ATG, Cyclosporine, and Promacta for Severe Aplastic Anemia. Neutrophils and whites have improved and HGB has bumped up a bit, but platelets still falling (down to 7 this past week).

My question concerns dosing and administration of Cyclosporine. I'm 150 lbs, so the recommended dose is 3mg per kg twice a day (400 total per day). This week my blood/Cyclo levels were .59, well below the 2-4 target, so doc wants to increase dosage to 600/day.

I'm just wondering what other AA patients have experienced with regard to taking Cyclo with or without food. I do a daily fast of 16 hours to help boost immune function, so taking it every 12 hours with food is not an option for me. But I've also heard that taking it with food may increase Cyclosporine blood levels.

Is a higher dose necessarily more toxic even if it's not showing up in the blood?

My preference is to minimize the dose, but I'd also like to maintain my eating schedule. NIH recommends spacing every 12 hours (not sure why), so this wouldn't be possible if I were to take with food.

Thanks for your feedback. Good luck to all.

Joe Starr