Uses
What is cyclosporine used for?
Cyclosporine is commonly used for the following conditions.
- Prevention of organ rejection, which is when your body is not accepting a transplanted organ, in kidney, liver, and heart transplantation. Cyclosporine may also be used for other organ transplants.
- Autoimmune disorders such as psoriasis and rheumatoid arthritis. In these disorders, the immune system, which normally protects us, mistakenly attacks parts of the body.
Cyclosporine may also be used for other conditions as determined by your healthcare provider.
How does cyclosporine work (mechanism of action)?
Cyclosporine works by stopping your body from making specific components of the immune system. This makes the immune system less active, so it does not attack parts of your body or recognize a transplanted organ.
How is cyclosporine supplied (dosage forms)?
Brands and other names
- Gengraf
- Neoral
- Sandimmune
Dosage forms and strengths
- 25 mg, 50 mg, and 100 mg oral capsules
- 100 mg/mL oral solution
Cyclosporine is also available in injectable forms.
Cyclosporine is also available as an eye drop for use in the eye. See Cyclosporine ophthalmic for more information.
How should I store cyclosporine?
Oral Capsules. Cyclosporine oral capsules should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). Store in a cool, dry place. Keep medicine in blister packs until ready to take.
Oral Solution. Cyclosporine oral solution should be stored at room temperature, between 68 F to 77 F (20 C to 25 C) for up to 2 months. Do not refrigerate or freeze. If room temperature falls below 68 F (20 C), the solution may thicken or start to form clumps. These clumps do not mean the medicine has gone bad and does not change how much you need to take. To change back into a solution, allow the medicine to sit at room temperature of 77 F (25 C). Throw out and replace any medicine two months after first opening it.
Side Effects
What are the most common side effects of cyclosporine?
The most common side effects of cyclosporine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- High blood pressure (see below)
- Kidney injury (see below)
- Low magnesium
- Excessive hair growth
- Seizures
- Uncontrollable shakiness that most commonly happens in the hands, arms, or legs
- Numbness in the hands and feet
- Headache
- Overgrowth of the gums
- Nausea, vomiting, or diarrhea
- High cholesterol
- Flu-like symptoms
There may be other side effects of cyclosporine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of cyclosporine?
While less common, the most serious side effects of cyclosporine are described below, along with what to do if they happen.
Severe Allergic Reactions. Cyclosporine may cause allergic reactions, which can be serious. Stop taking cyclosporine and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Kidney Injury (Acute Kidney Injury). Kidney injury can happen when taking cyclosporine. Keep all appointments to have your blood checked. Call your healthcare provider right away if you have any of the following symptoms.
- Reduced need to pee
- Swelling in your feet, ankles, or legs
- Weakness or unusual tiredness
- Difficulty catching your breath or chest pain/pressure
- Confusion
- Nausea
- Seizures
Liver Injury. Liver injury, also called hepatotoxicity, can happen when taking cyclosporine. Keep all appointments to have your blood checked. Call your healthcare provider right away if you have any of the following symptoms.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored urine (pee)
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
High Potassium Level (Hyperkalemia). Cyclosporine can cause a high potassium level, which can be serious and may lead to death. Your healthcare provider may check your potassium levels while you are taking cyclosporine, especially if you take certain other medicines. Call your healthcare provider right away if you have any of the following symptoms of a high potassium level.
- Muscle cramping or weakness
- Slow heartbeat or feeling of skipped heartbeats
- Trouble breathing
- Nausea, vomiting, or diarrhea
- Abnormal heart rhythm
Increased Blood Pressure (Hypertension). Cyclosporine may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while taking this medicine.
Small Blood Vessel Clots (Thrombotic Microangiopathy). Cyclosporine may cause thrombotic microangiopathy, which is when small blood clots form in blood vessels. Keep all your appointments to have your blood checked. This will help your healthcare provider tell if you have thrombotic microangiopathy.
Increased Risk of Infection. Cyclosporine reduces your ability to fight off infections. You may be at risk of getting an infection, which can be serious. Contact your healthcare provider if you have any of the following symptoms, which could be signs of an infection.
- Fever, sweats, chills, or muscle aches
- Feeling more tired than usual
- Sore throat
- Cough or coughing up blood
- Burning or stinging when you pee
- Shortness of breath
- Diarrhea or stomach pain
- Weight loss
Cancer. Cyclosporine can cause a new cancer to develop, including skin cancer, or cause a previously treated cancer to recur. Try to limit the time you spend in the sun and make sure you are protecting yourself by wearing protective clothing and/or sunscreen. Tell your healthcare provider about any new symptoms that you may get.
Nerve Problems. Nerves are the fibers that carry sensations from your body to your brain. Cyclosporine may cause problems with these nerves, which can be serious. Call your healthcare provider right away if you have any of the following symptoms of nerve problems.
- Headache
- Vision changes
- Difficulty moving or controlling parts of your body
- Uncontrollable shakiness that most commonly happens in the hands, arms, or legs
- Change in mental status such as confusion or trouble thinking clearly
- Seizures
- Muscle weakness
- Numbness or tingling
- Dizziness
Warnings & Precautions
Who should not use cyclosporine?
Allergies to Ingredients. People who are allergic to any of the following should not take cyclosporine.
- Cyclosporine
- Gengraf
- Neoral
- Sandimmune
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific cyclosporine products they stock.
Specific Conditions in People with Rheumatoid Arthritis or Psoriasis. People with rheumatoid arthritis or psoriasis who have kidney problems, high blood pressure that is not well managed, or cancer, should not take cyclosporine.
Interactions. If you have psoriasis, cyclosporine should not be taken while you are using certain other medicines or treatments. Before taking cyclosporine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about cyclosporine before taking it?
Do not take cyclosporine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share cyclosporine with other people, even if they have the same condition as you. It may harm them.
Your healthcare provider may obtain blood work and other tests before and after starting cyclosporine.
If you are taking cyclosporine oral solution, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
Cyclosporine oral solution may be mixed with specific beverages such as orange juice to make it taste better. Talk to your healthcare provider or pharmacist about which beverages may be acceptable to mix with cyclosporine oral solution.
Keep cyclosporine out of the reach of children.
What should I tell my healthcare provider before taking cyclosporine?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if cyclosporine is right for you.
In particular, make sure that you discuss any of the following.
Vaccines. Talk with your healthcare provider about any vaccines that you may need. You should not receive certain vaccines right before or while taking cyclosporine. Tell your healthcare provider about any vaccines you have recently received or have scheduled.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Kidney problems
- Liver problems
- Infections
- High blood pressure
- Seizures
- Cancer
Pregnancy. Your healthcare provider will advise you if you should take cyclosporine while you are pregnant or trying to get pregnant. It is not known if or how cyclosporine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. If you become pregnant while taking cyclosporine, you can register for the Transplant Pregnancy Registry International by calling 877-955-8677 or at www.transplantpregnancyregistry.org. This registry collects safety information about the use of cyclosporine during pregnancy.
Breastfeeding. Cyclosporine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take cyclosporine while breastfeeding.
Interactions
Does cyclosporine interact with foods or drinks?
Food may affect how much cyclosporine is absorbed by your body. Make sure you are always taking your medicine either with or without food.
Grapefruit or grapefruit juice can cause the amount of cyclosporine in your body to go up. Do not eat grapefruit or drink grapefruit juice while taking cyclosporine.
It is unknown if drinking alcohol will affect cyclosporine. The risk of confusion or headache may be increased if you drink alcohol while taking cyclosporine.
Does cyclosporine interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are taking.
In particular, make sure that you discuss if you are using any of the following before taking cyclosporine.
- Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancers
- Mycophenolate (Cellcept, Myfortic), which is a medicine that suppresses your immune system
- Coal tar, which is commonly used for psoriasis
- A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen (Motrin, Advil), naproxen (Aleve), diclofenac, sulindac and others, which are contained in many prescription and OTC products for pain, swelling, and fever
- An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
- Certain antibiotics, such as clarithromycin or erythromycin, which is a medicine used to treat bacterial infections
- An oral birth control pill
- Tacrolimus (Prograf, Envarsus XR, Astagraf) or sirolimus (Rapamycin), which is a medicine to suppress your immune system
- Diltiazem (Cardizem CD and others) or verapamil, which is a medicine used for high blood pressure and other conditions
- Amiodarone (Pacerone and others), which is a medicine used for an irregular heart rhythm (atrial fibrillation)
- Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
- A medicine for HIV or AIDS
- Ketoconazole, itraconazole (Sporanox, Tolsura), posaconazole (Noxafil), voriconazole (Vfend), or fluconazole, which is a medicine used for fungal infections
- A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
- Carbamazepine (Tegretol, Carbatrol, and others), or oxcarbazepine (Trileptal) which is a medicine commonly used to treat seizures or nerve pain
- St. John’s wort, which is a supplement that may be used to treat depression
- Rifampin or rifabutin, which is a medicine commonly used to treat an infection called tuberculosis
- Bosentan (Tracleer) or ambrisentan (Letairis), which is a medicine used to treat pulmonary hypertension
- A statin, such as atorvastatin (Lipitor and others), rosuvastatin (Crestor), simvastatin (Zocor), lovastatin (Altoprev), pitavastatin (Livalo, Zypitamag), or pravastatin (Pravachol), which is a medicine to lower cholesterol
Many other medicines may alter the blood levels of cyclosporine, and vice versa. Tell your healthcare provider about all medicines that you take or have recently taken. Also, tell your healthcare provider if you have psoriasis and are receiving light therapy or radiation therapy.
This may not be a complete list of medicines that can interact with cyclosporine. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally take too much cyclosporine?
If you or someone else has taken too much cyclosporine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of cyclosporine?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Cyclosporine?
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