Cyclosporine (By mouth)

Introduction

Cyclosporine (sye-kloe-SPOR-een)

Prevents organ rejection after a transplant. Also treats rheumatoid arthritis and psoriasis.

Brand Name(s)

Neoral, Sandimmune, Gengraf

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

Do not use this medicine if you have had an allergic reaction to cyclosporine or Cremophor® EL (polyoxyethylated castor oil). Do not use this medicine for rheumatoid arthritis or psoriasis if you have kidney problems, cancer, or uncontrolled high blood pressure. Do not use this medicine for psoriasis if you are also receiving PUVA or UVB therapy, methotrexate (Rheumatrex®), coal tar, or radiation treatment.

How to Use This Medicine

Capsule, Liquid Filled Capsule, Liquid

  • Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
  • Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.
  • Take this medicine the same way every day. This means take it at the same time and take it consistently, either with or without food.
  • This medicine may be used with other medicines that prevent organ rejection. Take all other medicines your doctor prescribed as part of your combination treatment.
  • Measure the oral liquid only with the dosing syringe that comes with the package. The dosing syringe should be wiped with a clean towel after it is used and stored in its container. Do not rinse it with water or other cleaning agents before or after use.
  • Mix the oral liquid in a drinking glass, not a plastic cup. You can mix it with milk, chocolate milk, apple juice, or orange juice to make it taste better, but do not mix Neoral® oral liquid with milk. Do not mix it with very cold or hot drinks. Stir well, and drink your medicine right away. Add some more juice or water and drink that too, so you get all of the medicine.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

  • Keep the medicine in the original container. Store at room temperature, away from heat and direct light. Do not keep this medicine in the refrigerator or freezer. Throw away any unused oral liquid after 60 days.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • There are many other drugs that can interact with cyclosporine. Make sure your doctor knows about all other medicines you are using.
  • Make sure your doctor knows if you are also using any other medicine that weakens the immune system, such as methylprednisolone (Decadron®), prednisolone, tacrolimus (Prograf®, Protopic®), or other steroids, cancer medicine, or radiation treatment.
  • Make sure your doctor knows if you are using pain or arthritis medicine (such as diclofenac, naproxen, sulindac, Advil®, Aleve®, Celebrex®, Voltaren®), medicine for seizures (such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, Depakote®, Dilantin®, Tegretol®, Trileptal®), or medicine to treat HIV or AIDS (such as indinavir, nelfinavir, ritonavir, saquinavir, Norvir®). Tell your doctor if you are also using melphalan (Alkeran®) or any medicine that can be hard on your kidneys.
  • Make sure your doctor knows if you are using medicine to treat an infection (such as azithromycin, ciprofloxacin, clarithromycin, erythromycin, gentamicin, nafcillin, quinupristin/dalfopristin, rifabutin, rifampin, trimethoprim/sulfamethoxazole, tobramycin, vancomycin, Bactrim®, Cipro®, Ery-tab®, Garamycin®, Mycobutin®, Rifadin®, Septra®), medicine for fungal infections (such as amphotericin B, fluconazole, itraconazole, ketoconazole, terbinafine, voriconazole, Diflucan®, Nizoral®), stomach medicine (such as cimetidine, ranitidine, Pepcid®, Tagamet®, Zantac®), or certain blood pressure medicines (such as diltiazem, enalapril, lisinopril, losartan, nicardipine, nifedipine, verapamil, Avapro®, Benicar®, Caduet®, Cozaar®, Diovan®, Lotrel®, Micardis®, Zestril®).
  • Make sure your doctor knows if you are also using birth control pills, medicine to lower cholesterol (such as atorvastatin, bezafibrate, fenofibrate, fluvastatin, lovastatin, pravastatin, simvastatin, Lipitor®, Tricor®, Zocor®), aliskiren (Tekturna®), colchicine (Colcrys®), allopurinol (Zyloprim®), amiodarone (Cordarone®, Pacerone®), bosentan (Tracleer®), bromocriptine (Parlodel®), danazol (Danocrine®), digoxin (Lanoxin®), etoposide (VePesid®), imatinib (Gleevec®), metoclopramide (Reglan®), nefazodone (Serzone®), octreotide (Sandostatin®), orlistat (Xenical®), repaglinide (Prandin®), sulfinpyrazone (Anturane®), ticlopidine (Ticlid®), or St. John's wort.
  • If you also use sirolimus (Rapamune®), take it 4 hours after you take cyclosporine.
  • Tell your doctor if you are using a diuretic (water pill, such as amiloride, spironolactone, triamterene, Aldactone®). Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
  • Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.
  • Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, cancer, an infection, or high blood pressure. Tell your doctor if you have heart problems, low cholesterol, or high potassium or low magnesium in the blood. Tell your doctor if you have digestion problems, such as problems absorbing nutrients from food.
  • Check with your doctor right away if you have any changes in how much or how often you urinate, blood in the urine, lower back pain, weight gain, or swelling of the feet or lower legs. These may be symptoms of a serious kidney problem, including BK virus. BK virus can cause a transplanted kidney to fail.
  • Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellow eyes or skin. These could be symptoms of a serious liver problem.
  • This medicine weakens your immune system, so you are more likely to get an infection. Call your doctor right away if you symptoms of an infection, such as fever, chills, headache, swelling, or redness.
  • Call your doctor right away if you have numbness or weakness on one side of your body, feel clumsy, or have trouble thinking clearly. Also call your doctor if you have any nerve problems or other unusual symptoms that concern you. Some rare and serious virus infections could happen, such as progressive multifocal leukoencephalopathy (PML) or polyoma virus-associated nephropathy (PVAN).
  • This medicine may increase your risk of skin cancer or cancer of the lymph nodes (lymphoma). Talk to your doctor if you have concerns about this risk.
  • This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. Stay out of the sun as much as possible.
  • Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
  • Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.You will also need to have your blood pressure monitored.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Black, tarry stools
  • Blood in your urine, cloudy urine, lower back or side pain, change in how much or how often you urinate
  • Chest pain
  • Confusion, weakness, uneven heartbeat, trouble breathing, numbness or tingling in your hands, feet, or lips
  • Dark-colored urine, pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, yellow skin or eyes
  • Fast, slow, or pounding heartbeat
  • Fever, chills, cough, sore throat, and body aches
  • New or worsen numbness, tingling, or loss of movement anywhere in your body
  • Rapid weight gain, swelling of your face, fingers, or lower legs
  • Seizures, tremors, fainting
  • Unusual bleeding, bruising, or weakness
  • Vision changes

If you notice these less serious side effects, talk with your doctor:

  • Acne, excess growth of hair around your lips, over your chin, chest, hands, or legs
  • Headache
  • Joint or muscle pain
  • Stomach upset, diarrhea, constipation, nausea, vomiting, loss of appetite
  • Swelling and bleeding of your gums

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: September 18, 2013

         
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