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Cyclosporine Medication: Uses, Dosage, and Important Side Effects
Key Points About Cyclosporine Medication
Cyclosporine is an immunosuppressant commonly used to treat conditions such as rheumatoid arthritis, psoriasis, and to prevent organ transplant rejection. It works by suppressing the immune system, which helps reduce inflammation or prevent the body from attacking its own tissues. Cyclosporine is available in various forms and strengths. Always consult your healthcare provider before starting or adjusting your dose. You can also reach out to one of our providers through telemedicine for personalized advice.
Cyclosporine Brand Names and Generic Information
US Brand Names: Gengraf, Neoral, Sandimmune
Cyclosporine is the generic name for this medication. The generic name refers to the active ingredient in the drug, while brand names are specific to the manufacturers.
Pharmacologic Category of Cyclosporine
Immunosuppressant Agent
Calcineurin Inhibitor
Cyclosporine Dosage Guidelines
Cyclosporine is prescribed for a variety of conditions, with the dosage tailored to the specific disease being treated. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them. You can also schedule a telemedicine visit with one of our providers for further guidance.
Cyclosporine Dosage for Rheumatoid Arthritis
Initial Dose: 2.5 mg/kg/day, divided into two doses (morning and evening).
Maintenance Dose: May be increased by 0.5 mg/kg/day after 8 weeks if necessary, up to a maximum of 4 mg/kg/day.
Duration: Long-term treatment, as directed by your healthcare provider.
Cyclosporine Dosage for Psoriasis
Initial Dose: 2.5 mg/kg/day, divided into two doses.
Maintenance Dose: May be increased by 0.5 mg/kg/day after 4 weeks if needed, up to a maximum of 4 mg/kg/day.
Duration: Typically used for short-term flare control.
Cyclosporine for Organ Transplant Rejection (Prophylaxis)
Initial Dose: 15 mg/kg/day, starting 4-12 hours before transplant surgery.
Maintenance Dose: 5-10 mg/kg/day, adjusted based on blood levels and the type of transplant.
Duration: Long-term use is required to prevent organ rejection.
Cyclosporine Dosage for Nephrotic Syndrome
Initial Dose: 5 mg/kg/day for adults with normal kidney function, divided into two doses.
Maintenance Dose: Adjusted based on response and kidney function.
Duration: Long-term treatment, as directed by your healthcare provider.
Cyclosporine for Dry Eye Syndrome (Ophthalmic)
Initial Dose: 1 drop of 0.05% ophthalmic solution in each eye twice daily (morning and evening).
Duration: Long-term use as needed for symptom control.
Cyclosporine Dosage for Autoimmune Hepatitis
Initial Dose: 3-5 mg/kg/day, divided into two doses.
Maintenance Dose: Adjusted based on response and liver function.
Duration: Long-term treatment, as directed by your healthcare provider.
Cyclosporine Dosage for Crohn’s Disease
Initial Dose: 5 mg/kg/day, divided into two doses.
Maintenance Dose: Adjusted based on response.
Duration: Typically short-term for flare control, but may be used long-term in some cases.
Cyclosporine Dosage for Ulcerative Colitis
Initial Dose: 4 mg/kg/day, divided into two doses.
Maintenance Dose: Adjusted based on response.
Duration: Short-term for flare control, with long-term use in some cases.
Cyclosporine Dosage for Atopic Dermatitis
Initial Dose: 2.5-5 mg/kg/day, divided into two doses.
Maintenance Dose: Adjusted based on response.
Duration: Short-term use for flare control.
Cyclosporine Dosage for Systemic Lupus Erythematosus
Initial Dose: 2.5-5 mg/kg/day, divided into two doses.
Maintenance Dose: Adjusted based on response.
Duration: Long-term treatment, as directed by your healthcare provider.
Cyclosporine Dosage Forms and Strengths
Capsules: 25 mg, 50 mg, 100 mg
Oral Solution: 100 mg/mL
Ophthalmic Solution (for dry eye): 0.05%
Contraindications for Cyclosporine Use
A contraindication is a specific situation or condition in which a medication should not be used because it may be harmful. Cyclosporine is a potent immunosuppressant, and there are several conditions where its use is not recommended.
Allergy to Cyclosporine: If you have a known allergy to cyclosporine or any of its ingredients, taking the medication could result in a severe allergic reaction, including rash, swelling, or difficulty breathing.
Uncontrolled Hypertension (High Blood Pressure): Cyclosporine can raise blood pressure, so it should not be used in patients with poorly controlled hypertension, as it could worsen their condition.
Kidney Disease: Cyclosporine can cause kidney damage, so it’s contraindicated in patients with pre-existing severe kidney dysfunction. Using it in these cases could lead to further kidney damage or failure.
Active Infections: Since cyclosporine suppresses the immune system, it should not be used in patients with active infections, as it could make it harder for the body to fight off the infection.
Certain Cancers: Cyclosporine may increase the risk of developing certain cancers, particularly skin cancer and lymphomas. Patients with a history of these cancers should avoid using cyclosporine.
Cyclosporine Drug Interactions
Cyclosporine can interact with several other medications, which may increase the risk of side effects or reduce the effectiveness of either drug. It’s important to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Ibuprofen (Advil, Motrin), Naproxen (Aleve) – These medications can increase the risk of kidney damage when taken with cyclosporine.
Statins: Atorvastatin (Lipitor), Simvastatin (Zocor) – Cyclosporine can increase the levels of these cholesterol-lowering medications in the blood, raising the risk of muscle damage (rhabdomyolysis).
Antibiotics: Erythromycin, Clarithromycin (Biaxin) – These antibiotics can increase cyclosporine levels in the blood, leading to a higher risk of side effects.
Antifungals: Ketoconazole, Fluconazole (Diflucan) – These medications can also increase cyclosporine levels, potentially leading to toxicity.
Calcium Channel Blockers: Amlodipine (Norvasc), Diltiazem (Cardizem) – These blood pressure medications can increase cyclosporine levels and may worsen side effects.
Herbal Supplements: St. John’s Wort – This herbal remedy can reduce the effectiveness of cyclosporine by lowering its levels in the blood.
Cyclosporine in Pregnancy
Is it safe to take cyclosporine when pregnant?
Cyclosporine is classified as a Category C drug during pregnancy, meaning there is not enough well-controlled research in humans to definitively confirm its safety. While animal studies have indicated potential risks to the fetus, the benefits of cyclosporine in certain situations—such as preventing organ transplant rejection—may outweigh these risks. If you are pregnant or planning to become pregnant, it is crucial to discuss the potential risks and benefits of cyclosporine with your healthcare provider. Our telemedicine providers are available to help you make an informed decision about using cyclosporine during pregnancy.
Cyclosporine While Breastfeeding
Is it safe to take cyclosporine while breastfeeding?
Cyclosporine is excreted in breast milk, which may pose risks to a nursing infant. The American Academy of Pediatrics advises against breastfeeding while taking cyclosporine due to the potential for immunosuppression and other side effects in the baby. If you are breastfeeding or plan to breastfeed, it is important to consult your healthcare provider about alternative treatments or whether it is safe to continue breastfeeding while on cyclosporine.
Estimated Cost of Cyclosporine Medication
The cost of a 30-day supply of cyclosporine can vary depending on the dosage and the pharmacy. Without insurance, using a GoodRX coupon, the estimated cost for a 30-day supply of cyclosporine (100 mg capsules) typically ranges from $150 to $300. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a discount service like GoodRX to find the most affordable option for your cyclosporine prescription.
Possible Alternatives to Cyclosporine
Depending on the condition being treated, alternative therapies or lifestyle changes may help manage symptoms. Always consult your healthcare provider before making any changes to your treatment plan. Our telemedicine providers are available to discuss these options with you.
- Rheumatoid Arthritis: Alternatives include methotrexate, biologics such as adalimumab (Humira), or lifestyle modifications like regular exercise and a balanced diet to help reduce inflammation.
- Psoriasis: Topical treatments, phototherapy, or biologics like etanercept (Enbrel) may be considered as alternatives to cyclosporine.
- Organ Transplant Rejection: Other immunosuppressants, such as tacrolimus (Prograf) or mycophenolate mofetil (CellCept), may be used to prevent rejection.
- Nephrotic Syndrome: Steroids or other immunosuppressants like rituximab (Rituxan) may be alternatives. Dietary changes, such as reducing sodium intake, can also help manage symptoms.
- Dry Eye Syndrome: Artificial tears, punctal plugs, or other medications like lifitegrast (Xiidra) may be considered.
- Autoimmune Hepatitis: Prednisone or azathioprine (Imuran) are commonly used alternatives to cyclosporine.
- Crohn’s Disease: Biologics like infliximab (Remicade) or lifestyle changes such as a low-residue diet may help manage symptoms.
- Ulcerative Colitis: Mesalamine (Asacol) or biologics like vedolizumab (Entyvio) may be considered as alternatives.
- Atopic Dermatitis: Topical corticosteroids, phototherapy, or biologics like dupilumab (Dupixent) may be alternatives.
- Systemic Lupus Erythematosus: Hydroxychloroquine (Plaquenil) or belimumab (Benlysta) may be considered as alternative treatments.
Recent Updates on Cyclosporine Research
Ongoing research continues to explore cyclosporine’s role in treating various autoimmune conditions and its long-term safety profile. Recent studies are focusing on optimizing cyclosporine dosing strategies to minimize side effects, particularly kidney damage and high blood pressure. Researchers are also investigating the potential benefits of combining cyclosporine with other immunosuppressants to improve outcomes in organ transplant patients. Additionally, new formulations, such as topical cyclosporine for skin conditions, are being studied to reduce systemic side effects. Staying informed about the latest research is important, and our telemedicine providers can help you understand how these updates may impact your treatment plan.
