Cyclosporine: What You Need to Know

Names of Medication

US Brand Names: Neoral, Sandimmune, Gengraf (Cyclosporine)

Pharmacologic Category

Cyclosporine is a calcineurin inhibitor immunosuppressant. Other medications in this category include Tacrolimus (Prograf), Pimecrolimus (Elidel), and Sirolimus (Rapamune).

Dosing

Cyclosporine is used to treat various diseases in adults. Never adjust your dose of medication without first speaking with your doctor. Here is a list of diseases and the corresponding Cyclosporine dosage:

Organ Transplant Rejection (Kidney, Liver, and Heart transplants)

: The initial dose is usually 15 mg/kg per day for the first 4 to 12 hours prior to transplantation. Maintenance dose varies based on individual response and usually ranges between 5 mg/kg to 10 mg/kg per day.

Rheumatoid Arthritis

: The initial dose is 1.25 mg/kg twice daily. Depending on the response, the dosage may be increased by 0.5 to 0.75 mg/kg/day after 8 weeks, and then again after 12 weeks, but should not exceed a maximum of 4 mg/kg/day.

Psoriasis

: The initial dose is 2.5 mg/kg/day, divided into two doses. The dose may be increased by 0.5 mg/kg/day after 4 weeks, with a maximum dose of 5 mg/kg/day.

Nephrotic Syndrome

: The initial dose is 2.5 mg/kg twice a day. The dose may be increased, but should not exceed 5 mg/kg/day.

Atopic Dermatitis

: The initial dose is 2.5 mg/kg/day, divided into two doses. The dose may be increased, but should not exceed 5 mg/kg/day.

Dry Eye Syndrome

: Apply 1 drop of 0.05% emulsion twice a day, approximately 12 hours apart.

Uveitis

: The dose is usually 2.5 mg/kg/day, divided into two doses.

Dosage Forms and Strengths

Cyclosporine is available in the following forms and strengths: 1. Capsules: 25 mg, 50 mg, and 100 mg. 2. Oral solution: 100 mg/mL. 3. Ophthalmic emulsion: 0.05%.

Administration Instructions

Take cyclosporine at the same time every day, consistently either with or without a meal. Do not stop taking the medication without talking to your doctor, as this could increase your risk of severe infection or organ transplant rejection.

Adverse Reactions and Side Effects

Cyclosporine may cause side effects, some serious, others less so. The frequency is listed in parentheses.

Kidney damage (common)

: As cyclosporine can be harmful to the kidneys, your doctor will monitor kidney function with blood tests. Kidney damage occurs because Cyclosporine reduces blood flow to the kidneys, causing them to work less efficiently.

High blood pressure (common)

: Cyclosporine can cause constriction of blood vessels, leading to increased blood pressure. Regular monitoring of blood pressure is necessary during treatment.

Tremors (common)

: Cyclosporine may cause tremors or shaking, which occur due to its effects on nerve signal transmission. Lowering the dose often reduces this side effect.

Hyperkalemia (high potassium levels, less common)

: Cyclosporine can increase potassium levels in your blood, leading to muscle weakness or heart rhythm disturbances. Regular blood tests are required to monitor potassium levels.

Hirsutism (excessive hair growth, less common)

: This happens due to the drug’s impact on hair follicle growth factors. Your doctor can advise on managing this side effect.

Contraindications to Taking Cyclosporine

A contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment. Here are some contraindications for Cyclosporine:

Allergy to Cyclosporine or its components

: If you have had an allergic reaction to Cyclosporine or any of its ingredients, you should not take this drug. An allergic reaction may involve hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.

Uncontrolled high blood pressure

: Due to the risk of Cyclosporine increasing blood pressure, those with uncontrolled hypertension should avoid this medication.

Kidney disease

: Cyclosporine can worsen kidney function, so individuals with kidney disease should not use this medication.

Drug to Drug Interactions

Several drugs can interact with Cyclosporine, such as:
St. John’s wort (Hypericum perforatum)
Phenobarbital (Luminal)
Carbamazepine (Tegretol)
Phenytoin (Dilantin)
Rifampin (Rifadin, Rimactane)

Cyclosporine in Pregnancy

Cyclosporine is classified as pregnancy category C. This means that risk cannot be ruled out, and the medication should only be used if the potential benefits justify the potential risk to the fetus. Always discuss the risks and benefits with your healthcare provider.

Cyclosporine while Breastfeeding

Cyclosporine does pass into breast milk, and potential risks to the nursing infant are not fully known. Mothers taking Cyclosporine should consult with their healthcare providers before deciding to breastfeed.

Estimated Cost of Medication

Without insurance, a 30-day supply of Cyclosporine may cost approximately $250 with a GoodRx coupon. Please note that this is only an estimate, and prices may vary depending on the pharmacy and location. Prices are also subject to change based on negotiated agreements between pharmacies and pharmaceutical companies.

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.

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.