A new approach for the determination of immunosuppressive drugs using HPLC-MS/MS and Cs+ adducts.

In this study a new principle of measurement in LC-MS/MS (liquid chromatography mass spectrometry) for determination of the immunosuppressive drugs sirolimus, everolimus, tacrolimus, and cyclosporin A has been introduced by using the Cs(+) ion as the product ion in the multiple reaction monitoring mode (MRM). Separation of the immunosuppressive agents was achieved using a phenyl-hexyl-RP column together with a ternary gradient elution profile, consisting of water, methanol and acetonitrile combined with 0.1% v/v formic acid and 0.1 mmol/l Cs+. Quantification was performed using cyclosporin D, ascomycin and 32-desmethoxy-rapamycin as internal standards. The inter-run precision of this new method, expressed as the coefficient of variation, was 2.57% for sirolimus, 2.11% for everolimus, 2.31% for tacrolimus and 2.11% for cyclosporin A.