Index
It is a medicine that can be acquired through a prescription. It is available as a generic medicine and as a brand-name drug.
Marcas comerciales: gengraf, neoral, sandimmune.
Sandimmune’s brand-name version is only used to prevent the rejection of a transplanted organ.
Presentation
Cyclosporine comes as an oral capsule, oral solution, eye drops, or injectable form.
Uses of ciclosporin
Cyclosporine reduces inflammation in active rheumatoid arthritis (RA) and severe psoriasis. It is also used to prevent the rejection of an organ transplant.
Functions
Cyclosporine is an immunosuppressive drug that reduces the body’s natural defenses.
The neoral works by weakening your immune system. White blood cells, part of your immune system, normally fight substances in your body that do not exist naturally, like a transplanted organ.
When people undergo an organ transplant, their immune system recognizes the graft as “foreign” and will start attacking it as it would with any invasive bacteria or virus.
Cyclosporine decreases the ability of specific white blood cells in the immune system to respond to this strange.
In the case of rheumatoid arthritis or psoriasis, cyclosporine prevents your immune system from attacking your body tissues by mistake.
Side effects of cyclosporine
The oral capsule of ciclosporin does not cause drowsiness but may cause other side effects:
Most common side effects
The most common side effects that occur with ciclosporin include:
- High blood pressure
- Low levels of magnesium in your body.
- Blood clots in your kidneys.
- Stomach ache.
- Hair growth in certain areas.
- Acne.
- Tremors
- Headache.
- Increase the size of your gums.
If these effects are mild, they may disappear in a few days or a couple of weeks. If they are more severe or do not go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor immediately if you have serious side effects. Call 911 if your symptoms seem life-threatening or think you have a medical emergency.
Serious side effects and their symptoms may include the following:
Hepatic injury
Symptoms may include:
- Blood in the urine.
- Dark urine.
- Yellowing of your skin or the whites of your eyes.
- Pain in the upper part of the abdomen.
Kidney damage
Symptoms may include blood in the urine.
Heart problems
Symptoms may include swelling of the feet or lower legs.
Lung problems
Symptoms may include difficulty breathing.
Interactions
The oral capsule of ciclosporin may interact with other medications, vitamins, or herbs that you may be taking.
It is essential to know that an interaction occurs when a substance modifies the proper functioning of a medication. This can cause damage or suppression that works well.
To help avoid interactions, your doctor should handle all your medications carefully.
Tell your doctor about all the medications, vitamins, or herbs you take. Talk to your doctor or pharmacist to find out how this medication might interact with another you are taking.
Examples of medications that can cause interactions with cyclosporine are listed below.
Antibiotics
Taking cyclosporine with certain antibiotics can lead to higher cyclosporine levels in your body. This can increase your risk of side effects, especially kidney damage.
These medications include:
- Ciprofloxacin.
- Gentamicin.
- Tobramycin.
- Bactrim.
- Azithromycin.
- Clarithromycin.
- Erythromycin
- Quinupristin/dalfopristin.
The following antibiotics can decrease the amount of cyclosporine in your body. This can cause cyclosporine not to work as well as it should. When cyclosporine is used to prevent rejection, this could lead to denial of a transplanted organ.
These medications include:
- Nafcillin.
- Rifampin.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Taking cyclosporine with these medications can increase your risk of kidney damage.
These medications include:
- Ibuprofen.
- Sulindac.
- Naproxen .
- Diclofenac.
- Antifungals
Taking cyclosporine with certain antifungal medications can lead to higher cyclosporine levels in your body. This can increase your risk of kidney damage.
Examples of these medications include:
- Amphotericin B.
- Ketoconazole
- Fuconazol.
- Itraconazole .
- Voriconazole.
Terbinafine, another antifungal, can decrease the amount of cyclosporine in your body. This can cause cyclosporine not to work as well as it should. When cyclosporine is used to prevent rejection, this could lead to denial of a transplanted organ.
Drugs for acid reflux
Taking cyclosporine with these medications can increase your risk of kidney damage.
Examples of these medications include:
- Ranitidine .
- Cimetidine
- Contraceptive drugs
Taking cyclosporine with medications used for birth control can increase the amount of cyclosporine in your body. This can cause harmful side effects.
Inhibitory drug of immunity
Tacrolimus may increase your risk of kidney damage if you take it with ciclosporin.
High cholesterol drugs
Taking ciclosporin with the following cholesterol medications may increase your risk of kidney damage:
When you take cyclosporine with other cholesterol medications, the concentration of these medications in your body may increase. This can cause side effects such as muscle pain and weakness.
These medications include:
- Atorvastatin.
- Simvastatin.
- Lovastatin.
- Pravastatin
- Fluvastatin.
Drugs for blood pressure
These medicines can increase the amount of cyclosporine in your body. This can cause harmful side effects.
Examples of these medications include:
- Aliskiren.
- Diltiazem.
- Nicardipine.
- Verapamil.
- Corticosteroid.
Methylprednisolone may increase the amount of cyclosporine in your body.
This can cause harmful side effects.
Anticonvulsants
These medicines can decrease the amount of cyclosporine in your body. This can cause cyclosporine not to work as well as it should. When cyclosporine is used to prevent rejection, this could lead to denial of a transplanted organ.
Examples of these medications include:
- Carbamazepine
- Oxcarbazepine.
- Phenobarbital.
- Phenytoin
- Herbs.
The St. John’s wort can decrease the amount of cyclosporine in your body. This can cause cyclosporine not to work as well as it should. When cyclosporine is used to prevent rejection, this could lead to denial of a transplanted organ.
Hepatitis
If you take certain anti-hepatitis medications, consult your doctor before taking cyclosporine. Your doctor may need to reduce your dose of ciclosporin to prevent side effects.
These medications include:
- Boceprevir.
- Telaprevir.
Drugs of the human immunodeficiency virus (HIV)
If you are taking medicines called protease inhibitors to treat HIV, consult your doctor before taking cyclosporine. Your doctor may need to reduce your dose of ciclosporin to prevent side effects.
Examples of these medications include:
- Idinavir.
- Nelfinavir.
- Ritonavir.
- Saquinavir.
Liquid reducing drugs
Do not take cyclosporine with these medications. It can increase the amount of potassium in your body and can cause harmful side effects. These side effects can include a slow heart rate, fatigue, muscle weakness, and nausea.
These medications include:
- Triamterene.
- Amiloride.
Drugs against cancer
Tomarcyclosporin with these medications can increase the amounts of these medications in your body. This can increase your risk of side effects.
Examples of these medications include:
- Ambrisentan.
- Danorubicina.
- Doxorubicin
- Etoposide
- Mitoxantrone.
Taking melphalan, another cancer medication, with cyclosporine may increase your risk of kidney damage.
Other drugs
Taking cyclosporine with any of the medications listed below can cause more of these medications in your body. This can increase your risk of side effects.
These medications include:
- Bosentan.
- Dabigatran.
- Digoxin.
- Prednisolone.
- Repaglinide.
- Sirolimus.
Other medicines can increase the amount of cyclosporine in your body. This can cause harmful side effects.
These medications include:
- Amiodarone .
- Bromocriptina.
- Danazol.
- Imatinib.
- Metoclopramida.
- Nefazodona.
Other medications can decrease the amount of cyclosporine in your body. This can cause cyclosporine not to work as well as it should. When cyclosporine is used to prevent rejection, this could lead to denial of a transplanted organ.
Examples of these medications include:
- Octreotide.
- Orlistat.
- Sulfinpyrazone.
- Ticlopidine.
Other warnings
Food interaction warning
Avoid eating grapefruit or drinking grapefruit juice while taking this medication. The consumption of grapefruit products can increase the amount of cyclosporine in your body.
Warnings for people with certain health conditions
For people with kidney and liver disorders: cyclosporine can cause kidney and liver disease. High doses of ciclosporin can worsen if you already have kidney or liver problems.
Cyclosporine may increase the risk of severe viral infections, such as polyomavirus infection, for people with serious illnesses. This can be very serious and can even be fatal.
Warnings for other groups
For pregnant women: Cyclosporine is a category C pregnancy medication.
That means two things:
- Animal research has shown adverse effects for the fetus when the mother takes the drug.
- There have not been enough studies on humans to determine how the medication could affect the fetus.
- Talk to your doctor if you are pregnant or plan to become pregnant.
- Cyclosporine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Cyclosporine passes through breast milk for breastfeeding women and can cause serious adverse effects. Tell your doctor if you are breastfeeding. You and your doctor must decide if you will breastfeed or take cyclosporine.
Branded Sandimmune capsules contain ethanol (alcohol). Ethanol and other substances in the medication can pass through breast milk and cause severe effects in a breastfed child.
For seniors: If you are 65 or older, you are more likely to develop high blood pressure if you use cyclosporine. As you get older, your organs, like the liver and kidneys, do not work as well as they used to.
To prevent kidney damage, your doctor may start with a lower dose.
For children who had a kidney, liver, or heart transplant: children six months and older who received certain organ transplants and were treated with ciclosporin had no unusual side effects.
Those who have rheumatoid arthritis or psoriasis: the effectiveness and safety of cyclosporine have not been established in people under 18 who have rheumatoid arthritis or psoriasis.
Dosage
All possible doses and forms may not be included here. Your dose, setup, and how often you will take it will depend on:
- Age.
- The condition that is being treated.
- How serious is your situation?
- Other medical conditions you have.
- How you react to the first dose
Dosage for rheumatoid arthritis
Generic: cyclosporine.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: Gengraf.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: neoral.
Form: oral capsule.
Strengths: 25 mg and 100 mg.
Dosage for adults (over 18 years).
The dose is based on weight.
The initial dose is 2.5 mg/kg per day, divided into two doses.
The maximum dose is 4 mg/kg per day.
Stop taking cyclosporine if you do not get good results after 16 weeks of treatment.
Dosage for psoriasis
Generic: ciclosporin
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: Gengraf.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: neoral.
Form: oral capsule.
Strengths: 25 mg and 100 mg.
Dosage for adults (over 18 years).
The dose is based on weight.
The initial dose is 2.5 mg/kg per day, divided into two doses (1.25 mg/kg).
The maximum dose is 4 mg/kg per day.
After six weeks of treatment, stop taking cyclosporine if you do not get good results.
Dosage to prevent rejection of kidney, liver, and heart transplants
Generic: cyclosporine.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: Gengraf.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Brand: neoral.
Form: oral capsule.
Strengths: 25 mg and 100 mg.
Brand: Sandimmune.
Form: oral capsule.
Strengths: 25 mg, 50 mg and 100 mg.
Dosage for adults (over 18 years).
The dose of ciclosporin can vary, depending on your body weight, the organ transplanted, and other medications.
The generic and all brands except Sandimmune: the dose may vary. The typical daily dose is 7-9 mg per kilogram (kg) of body weight taken in two uniform doses evenly spaced throughout the day.
Sandimmune:
Take your first dose 4-12 hours before transplant. This dose is typically 15 mg/kg. Your doctor can give you a dose of 10-14 mg/kg per day.
Continue taking the same dose after transplant surgery for 1 to 2 weeks. After that, reduce by 5 percent per week to a maintenance dose of 5-10 mg/kg per day.
Dosage for children (ages 1-17 years).
The dose of ciclosporin will vary, depending on your child’s body weight, the organ transplanted, and other medications your child is taking.
The generic and all brands except Sandimmune: the dose may vary. The typical daily dose is 7-9 mg per kilogram (kg) of body weight taken in two uniform doses evenly spaced throughout the day.
Continue taking the same dose after transplant surgery for 1 to 2 weeks. After that, reduce by 5 percent per week to a maintenance dose of 5-10 mg/kg per day.
Special dosing considerations
For people with kidney disorders: cyclosporine can cause kidney disease. If you already have kidney problems, your doctor may reduce your dose of ciclosporin.
For people with liver disorders: cyclosporine can cause liver disease. If you already have liver problems, your doctor may reduce your dose of ciclosporin.
Take as directed
Cyclosporine is used for long-term treatment. It includes severe risks if you do not take it as prescribed.
If you do not take it at all: your body can reject your transplanted organ, or your symptoms of RA or psoriasis can come back.
If you stop taking it suddenly: do not stop taking this medicine. Your body can refuse your transplant and may experience increased side effects if you do. Your symptoms of RA or psoriasis may return.
If you do not take it in time: your body can refuse your transplant, causing severe health problems. Your symptoms of RA or psoriasis may return.
What to do if you miss a dose: if you miss a dose, take it as soon as you can. However, skip the missed dose if they are only a few hours until your next dose.
Do not try to catch up by taking two doses at a time. This could cause dangerous side effects.
How to know if the medication is working: you can know if the medicine is working if:
- Your body does not reject the transplanted organ or tissue.
- You have fewer symptoms of rheumatoid arthritis.
- You have fewer psoriasis plaques.
Important considerations
- Consider these considerations if your doctor prescribes cyclosporine.
- Take cyclosporine at the same time every day.
- Do not crush, chew, or cut cyclosporin capsules.
Storage
- Store at room temperature between 68 ° F and 77 ° F (20 ° C and 25 ° C).
- Once opened, use the medication within two months.
- Keep this medicine away from light and high temperatures.
- Keep in mind that you can detect an odor when you open the container for the first time. This will disappear with time.
- Do not store this medication in damp or humid areas, such as bathrooms or kitchens.
Refills
A prescription for this medication is rechargeable. You should not need a new drug for this medication to be refilled. Your doctor will write the number of authorized refills in your prescription.
In case of travel
When traveling with your medicine:
- Always take your medication with you. When you fly, never put it in a checked bag. Keep it in your handbag.
- Do not worry about the airport X-ray machines. They can not harm your medication.
- You may need to show the airport staff the pharmacy label for your medication. Always carry the original box with the prescription label.
- Do not put this medication in the glove compartment of your car or leave it in the car. Be sure to avoid doing this when it is very hot or cold.
- Talk to your pharmacist before traveling to ensure you have enough of this medication.
- Depending on where you travel, you may have trouble getting this medication.
Self-management
Avoid taking too much sunlight or tanning booths if you are taking generic cyclosporine or a brand-name medication that is not Sandimmune.
Clinical monitoring
Your doctor can monitor you with specific blood tests before and during treatment with cyclosporine. This is to make sure it is safe for you. You can do tests to check things like your:
- Cyclosporin levels.
- Liver function
- The function of the kidney.
- Levels of cholesterol.
- Magnesium level
- Potassium level
