Medication Profile: Cyclosporine

Summary or Key Points

Cyclosporine is a vital medication used to prevent organ transplant rejection and treat certain autoimmune diseases. It works by suppressing the body’s immune system to prevent it from attacking the transplanted organ or overreacting, causing inflammation in conditions like rheumatoid arthritis and psoriasis. Always consult your healthcare provider, who you can conveniently reach via telemedicine, before making any changes to your medication.

Names of Medication

US Brand Name: Neoral, Sandimmune, Gengraf
(Generic Name: Cyclosporine)

A ‘generic name’ refers to the official medical name of the drug, without any branding. It’s the name of the medication in its basic, unbranded form. This is usually what’s enclosed in parentheses.

Pharmacologic Category

Cyclosporine is part of the pharmacologic category called ‘Immunosuppressants’. Other medications in this category include Prednisone, Azathioprine, Mycophenolate mofetil, and Tacrolimus.

Dosing

Cyclosporine is used to treat a variety of conditions and the dosing will depend on the specific condition being treated. Always consult your healthcare provider before adjusting your dose. Remember, our providers are readily available via telemedicine for your convenience.

• Organ Transplant Rejection Prevention: The initial dose is typically 15 mg/kg given 4-12 hours prior to transplantation. Post-transplant, the dose may be gradually reduced, depending on the patient’s response.
• Rheumatoid Arthritis: The initial dose is usually 2.5 mg/kg/day, divided into two doses. Your doctor may adjust this dose based on your response and any side effects you may experience.
• Psoriasis: The starting dose is generally 2.5 mg/kg/day, divided into two doses. This may be increased by your doctor, depending on your response and tolerance to the medication.

Dosage Forms and Strengths

Cyclosporine is available in the following forms and strengths:

• Capsule (liquid-filled): 25 mg, 100 mg
• Oral solution: 100 mg/mL

Administration Instructions

Cyclosporine should be taken as directed by your healthcare provider. The medication is usually taken with a full glass of water on an empty stomach, an hour before or two hours after a meal. If you experience nausea, you may take it with food. However, consistency is important for optimal absorption. Ensure to follow your healthcare provider’s directions closely, and do not hesitate to contact our providers via telemedicine if you have any questions.

Adverse Reactions and Side Effects

Like all medications, Cyclosporine can have side effects. The frequency of these side effects varies among individuals. Always contact your healthcare provider if you experience any adverse reactions, and remember, our telemedicine providers are here to assist you.

• Common (may affect up to 1 in 10 people): High blood pressure, kidney problems, headache, trembling, increased hair growth, and gum hypertrophy.
• Uncommon (may affect up to 1 in 100 people): Nausea, vomiting, diarrhea, stomach pain, liver problems, and muscle cramps.
• Rare (may affect up to 1 in 1,000 people): Seizures, mental changes, pancreatitis, skin changes (including increased sensitivity to sunlight), and changes in vision.

Contraindications

A ‘contraindication’ is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. Cyclosporine has several contraindications:

• Allergy to cyclosporine or its components: People who are allergic to cyclosporine or any of its ingredients should avoid it because it can trigger allergic reactions.
• Uncontrolled high blood pressure: This medication can increase blood pressure, so it’s contraindicated in individuals with uncontrolled hypertension.
• Certain kidney problems: Cyclosporine can harm the kidneys, so it should not be used in individuals with certain kidney conditions.
• Certain types of cancer: As an immunosuppressant, cyclosporine might increase the risk of developing certain cancers.

Drug to Drug Interactions

Certain medications can interact with Cyclosporine, altering its effectiveness or causing side effects. Some of these include:

• St. John’s Wort (Hypericum perforatum)
• Amphotericin B (Fungizone, Ambisome)
• NSAIDs such as Ibuprofen (Advil, Motrin)
• Angiotensin-converting enzyme (ACE) inhibitors such as Lisinopril (Prinivil, Zestril)

Cyclosporine in Pregnancy

Cyclosporine may be used during pregnancy if the potential benefits outweigh the risks. It’s important to discuss this with your healthcare provider, ideally before becoming pregnant. Our telemedicine providers are readily available to help you navigate these important conversations.

Cyclosporine while Breastfeeding

Small amounts of cyclosporine can pass into breast milk. Therefore, it is generally recommended to avoid breastfeeding while taking this medication. Always consult your healthcare provider for personalized advice. Our telemedicine service makes it easy to have this conversation from the comfort of your home.

Estimated Cost of Medication

The estimated cost of a 30-day supply of Cyclosporine without insurance, using a GoodRX coupon, is about $85-$105. However, prices may vary depending on your location and the specific pharmacy.

Possible Alternatives

There are several possible alternatives to Cyclosporine, depending on your specific health situation. Always discuss these with your healthcare provider before making any changes to your treatment plan. Consult our telemedicine providers who can guide you through this process.

• Organ Transplant Rejection Prevention: Alternatives may include Tacrolimus (Prograf) and Sirolimus (Rapamune).
• Rheumatoid Arthritis: Other treatments may include Methotrexate (Rheumatrex, Trexall), Tumor Necrosis Factor inhibitors like Etanercept (Enbrel), and regular exercise.
• Psoriasis: Alternatives may include Topical corticosteroids, Light therapy, and Biologics like Adalimumab (Humira).

Recent Updates on Cyclosporine Research

Research into Cyclosporine and its uses continues. Recent studies have been investigating the use of Cyclosporine in other autoimmune diseases and in certain types of cancer. The focus is on determining the optimal dosing to balance the medication’s effectiveness against its potential side effects. Always stay in touch with your healthcare provider to keep up-to-date with the latest information on your medications. Our telemedicine service is an excellent resource for staying informed and proactive about your health.

Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.