Common brand names: Neoral, Sandimmune
Why is this drug prescribed?
Cyclosporine is an immunosuppressive medication that prevents organ rejection by interfering with the body’s normal immune response.
The body’s immune system protects you from infection. Immune cells recognize the transplanted kidney as different from the rest of the body and attempt to destroy it; this is called rejection and is your body’s way of not accepting the new organ.
After transplant surgery, you are prescribed immunosuppressive drugs to "fool" your immune system into thinking your new kidney is your own, so it doesn’t try to attack it.
How and when should cyclosporine be taken?
Cyclosporine is available as soft gelatin capsules or oral solution (an olive-oil based liquid). The oral solution is best mixed with chocolate milk or orange juice. The soft gelatin capsules are available in two strengths, 25 mg and 100 mg—each is different in size and color. Packaged individually, these capsules should be left in the foil containers until used. Once open, they must be used within seven days. Cyclosporine may be taken with water on an empty or full stomach.
Cyclosporine is generally taken twice a day; take the morning dose with breakfast. The second dose should be taken 12 hours after the first dose. Be sure to take the prescribed doses at the same time every day.
Your prescription label tells you how much to take at each dose and how often to take it. Follow these instructions carefully and ask your pharmacist or doctor to explain any part that you do not understand.
It is important that you take this medication regularly as prescribed; do not stop taking it. You will need to take immunosuppressant drugs every day for the rest of your life to prevent rejection.
Your health care provider may reduce or even stop cyclosporine when you are being treated for certain infections. This allows your body to effectively fight the infection.
What special instructions should I follow while using this drug?
- All of the prescribed amount of cyclosporine must be taken to maintain enough immunosuppression to prevent rejection. Follow your dosage schedule carefully.
- Be sure that you always have enough medication on hand. Check your supply before holidays or other occasions when you may be unable to fill your prescription.
- Keep all appointments with your doctor and the laboratory so that your response to the drug can be monitored.
- Do not have any vaccinations without your doctor’s approval.
- Take precautions to avoid infection while taking this medication.
- All of the prescribed amount of cyclosporine must be taken to maintain enough immunosuppression to prevent rejection.
- Follow your dosage schedule carefully.
What should I do if I forget to take a dose?
If you forget to take a dose, take it as soon as you remember. If it is almost time for your next dose, it is permissible to take a double dose; then return to your regular dosage schedule.
If you have forgotten more than one dose, contact the Transplant Center for instructions.
What are the side effects of this drug?
Even though the side effects of cyclosporine could be very serious, remember that this drug is necessary to prevent rejection. Precautions will be taken to detect these side effects and treat them before they become harmful.
Please see the guidelines below to reduce complications while taking cyclosporine.
Cyclosporine may cause any of these side effects:
- Flushing—a brief period of warmth and/or redness in your face for 1-2 hours after taking cyclosporine. This feeling disappears within a short time.
- Hair growth—increased hair on your face (arms and body is common) but usually not a problem
- Fine tremors of the hands—experiencing a trembling of the hands is common, especially during the first month of taking cyclosporine. The tremor is usually mild and tends to disappear the longer you take the medication, or when your dosage is decreased.
- Gum swelling and mouth sensitivity to cold or heat—meticulous daily hygiene is necessary to keep gums in good health.
- Hypertension (high blood pressure)—appropriate medication will be prescribed to control your blood pressure. It is important to follow other recommendations to help lower your blood pressure.
- Altered kidney function (nephrotoxicity)—blood tests will be performed frequently to measure BUN and creatinine levels to detect changes in kidney function. Elevated levels of these substances may indicate altered kidney function.
- Neurological symptoms—headache and feeling that it’s harder to remember.
- Drug interactions—several drugs affect metabolism or excretion of cyclosporine and must be used with caution. You need to verify all new medications with the Transplant Team.
What storage conditions are necessary for this drug?
- Store this medication at room temperature. Do not freeze or expose to heat over 77 degrees Fahrenheit.
- If you are traveling, store your cyclosporine in an insulated container.
- Do not store this medication in direct heat or light.
- Do not store this medication in the bathroom, near the kitchen sink or in other damp places. Heat or moisture may cause it to break down.
- Keep this medication in the container it came in, tightly sealed.
- Store capsules in foil container until ready to use. Once opened, capsules need to be used within 7 days.
- Solution can be used for 60 days after opening.
- Do not use this medication after the expiration date on the bottle (about 2 years after it is manufactured).
- Keep it and other medications out of the reach of children.
- Store this medication at room temperature.
- Do not freeze or expose to heat over 77 degrees fahrenheit.
When should I call my health care provider?
Call your health care provider right away if you have any of these warning signs of infection: Call your health care provider if you have any of these warning signs of infection:
- Fever over 100°F(38°C)
- Sweats or chills
- Skin rash
- Pain, tenderness, redness or swelling
- Wound or cut that won’t heal
- Red, warm or draining sore
- Sore throat, scratchy throat or pain when swallowing
- Sinus drainage, nasal congestion, headaches or tenderness along upper cheekbones
- Persistent dry or moist cough that lasts more than two days
- White patches in your mouth or on your tongue
- Nausea, vomiting or diarrhea
- Flu-like symptoms (chills, aches, headache or fatigue) or generally feeling "lousy"
- Trouble urinating: pain or burning, constant urge or frequent urination
- Bloody, cloudy or foul-smelling urine or black, tarry stools
Also contact your health care provider if you have any other symptoms that cause concern or if you have any questions.
| Possible Side Effects |
What You Should Do |
| Increased risk of infection |
Avoid anyone who may have an infection and report any signs or symptoms of infection to your health care provider. |
| Increased risk of cancer |
Visit your primary care physician regularly and have a yearly prostate or gynecologic exam. Report any changes to your health care provider. |
| Swollen or bleeding gums |
Practice good oral hygiene to prevent swollen gums from becoming infected. Brush your teeth and gums thoroughly after each meal with a small, soft toothbrush and fluoride toothpaste. Use foam sticks instead of a toothbrush if your gums are especially sore. Keep dentures clean and fitting properly and floss daily. Report any mouth sores to your health care provider. Visit your dentist every six months, and notify your transplant physician before any dental procedures. |
| Decreased white blood cell count |
Have your blood drawn regularly so your health care providers can monitor your white blood cell count. |
| Excess hair growth |
To remove unwanted hair, use safe bleaching techniques or creams. |
| Liver Damage |
Visit your physician regularly and have your blood drawn as scheduled. Report any changes in the color of your urine, eyes or skin. |
| Kidney Damage |
Report any changes in urine output, weight or swelling during your regular physician visits. |
| Tremors or seizures |
Report any trembling, shaking or seizures to your physician. Your dosage may need to be adjusted. |
| High blood pressure |
Take your medication as prescribed and limit salt and fluid in your diet. |
For More Information
If you have any questions or concerns, please call us at 216.444.6996. We will be happy to answer your questions.