Reply To: Tacro/Cyclosporine levels

  • Nancy Noonan

    May 3, 2022 at 12:13 pm

    Our center uses multiple CNI agents and they are all addressed in the same fashion:  routine troughs are drawn on Mon and Thurs; then also following dose adjustments.  The laboratory has very limited capacity to run levels on the weekends, so we try not to do so unless it is a confirmed urgent/emergent patient safety issue. If the specimens are received in the lab by 9am-ish, we can except the result to be available in the early afternoon; otherwsie, they are run the following day. 

    We time the infusion so that troughs can easily be acquired with the morning labs (often drawn between 04 and 06 on night shift.  When medication route changes to oral, we change the administration times to a more reasonable ‘daytime’ hour and re-time all morning labs to coincide with the trough level timing (e.g. 8am or 9am).

    Nancy Noonan, MS,RN,BMTCN,CNS
    UCSF Benioff Children’s Hospital Oakland
    Oakland, California 94609
    Original Message:
    Sent: 05-03-2022 07:29 AM
    From: Jessica Murphy
    Subject: Tacro/Cyclosporine levels

    He don’t do much CSA, but do tacro and siro levels whenever our patients need them – no set schedule. Our lab runs them every day until 2pm. Patients have them checked every 2-3 days until stable, then typically twice weekly or whenever they are coming to clinic (could be every other week if they’ve been stable for awhile.

    Pediatric Oncology/BMT Nurse Practitioner
    Johns Hopkins Hospital
    Baltimore, MD USA

    Original Message:
    Sent: 05-03-2022 07:17 AM
    From: Kelli Sheehan
    Subject: Tacro/Cyclosporine levels

    We have standing orders to draw our Tacro/Cyclosporine levels every Monday and Thursday.  Then, if there is a dose modifiation, we will draw a level after the 3rd dose after any dose modification. 


    Kelli Sheehan BSN, RN CPHON

    Staff Nurse Level III

    Hematopoietic Stem Cell Transplant

    Boston Children’s Hospital




    Original Message:
    Sent: 5/2/2022 2:58:00 PM
    From: Theresa Decker
    Subject: Tacro/Cyclosporine levels

    Hello all,

    We are just wanting to know how often people draw tacro/cyclosporine levels in the BMT population.

    Thanks so much!

    Theresa Decker BSN, RN, CPHON
    Education Coordinator Hem/Onc/BMT
    Children’s Mercy Kansas City