- Immunosuppressive medications
- Ciclosporin and Tacrolimus
- Mainstay of most modern immunosuppressive protocols
- Structurally distinct but work through same pathway - Calcineurin inhibitor
- Block activity of calcineurin within the cytoplasm of the T cell
- Calcineurin plays a critical role in transcription of IL-2, (the main T-cell growth factor) and other cytokines after T-cell activation
- Blocks cytokine synthesis
- Similar efficacy, choice between two is unit preference
- Share a number of side effects
- Most notable is nephrotoxicity
- May reduce dose if renal transplant has ATN
- Action depends on blood concentration – needs monitoring!