Cyclosporine (sye-kloe-SPOR-een)

Helps prevent organ rejection after transplant surgery. Also treats rheumatoid arthritis and psoriasis.

Brand Name(s):

Gengraf, Neoral, SandIMMUNE

When This Medicine Should Not Be Used:

How to Use This Medicine:

Capsule, Liquid Filled Capsule, Liquid

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Take this medicine the same way every day. This means take it at the same time and always take it with food or always without food.
• Oral liquid: Measure the oral liquid with the included dosing syringe. Wipe the syringe with a clean towel after use and replace the cover. Do not rinse the syringe or allow any water to get into the medicine container.
  • Neoral® oral liquid may be added to a glass of room temperature apple juice or orange juice. Stir well, and drink the mixture right away. Add more juice to the glass and drink that too, so you get all of the medicine. Do not use a plastic cup.
  • Sandimmune® oral liquid may be added to a glass of room temperature milk, chocolate milk, or orange juice. Stir well, and drink the mixture right away. Add more milk or juice to the glass and drink that too, so you get all of the medicine.
• Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not store it in the refrigerator. Throw away any unused oral liquid 60 days after the bottle is opened for the first time.

Drugs and Foods to Avoid:

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

• Some medicines can affect how cyclosporine works. Tell your doctor if you are using any of the following:
  • Aliskiren, allopurinol, ambrisentan, amiodarone, amphotericin B, bezafibrate, boceprevir, bosentan, bromocriptine, dabigatran, danazol, daunorubicin, digoxin, doxorubicin, etoposide, fenofibrate, fluconazole, imatinib, itraconazole, ketoconazole, melphalan, methotrexate, metoclopramide, mitoxantrone, mycophenolate mofetil, nafcillin, nefazodone, octreotide, orlistat, repaglinide, rifabutin, rifampin, St John's wort, sulfinpyrazone, tacrolimus, telaprevir, terbinafine, ticlopidine, voriconazole
  • Birth control pills
  • Blood pressure medicine (including diltiazem, nicardipine, verapamil)
  • Diuretics (water pill)
  • Medicine to treat cholesterol (including atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin)
  • Medicine to treat HIV infections (including indinavir, nelfinavir, ritonavir, saquinavir)
  • Medicine to treat infections (including azithromycin, ciprofloxacin, clarithromycin, erythromycin, gentamicin, quinupristin/dalfopristin, tobramycin, trimethoprim/sulfamethoxazole, vancomycin)
  • NSAIDs or pain medicine (including azapropazone, colchicine, diclofenac, naproxen, sulindac)
  • Seizure medicine (including carbamazepine, oxcarbazepine, phenobarbital, phenytoin)
  • Steroid medicine (including methylprednisolone, prednisolone)
  • Stomach medicine (including cimetidine, ranitidine)
• You should not use cyclosporine if you are receiving other treatment for psoriasis, including coal tar or radiation treatment (including PUVA or UVB treatment).
• If you are using sirolimus, take it 4 hours after you use cyclosporine.
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
• This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, anemia, a bleeding disorder, high blood pressure, eye or vision problems, or a history of seizures, skin cancer, or lymphoma.
• This medicine may cause the following problems:
  • Kidney problems
  • Liver problems
  • Increased risk of serious infections
  • Increased risk of cancer, including skin cancer or lymphoma
  • High blood pressure
  • Thrombotic microangiopathy (damage in the smallest blood vessels) and hemolytic anemia
  • Brain problems, including posterior reversible encephalopathy syndrome (PRES)
• This medicine may cause dizziness, confusion, or sleepiness. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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
• Change in how much or how often you urinate, bloody urine
• Chest pain, coughing up blood
• Confusion, weakness, uneven heartbeat, trouble breathing, or numbness in your hands, feet, or lips
• Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
• Fast heartbeat, dizziness, headache, vision changes
• Fever, chills, cough, sore throat, body aches
• Numbness or weakness in your arm or leg, or on one side of your body, pain in your lower leg
• Rapid weight gain, swelling in your face, hands, feet, or lower legs
• Seizures or tremors
• Sudden or severe headache, problems with vision, speech, or walking
• Tiredness
• Unusual bleeding, bruising, or weakness

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

• Diarrhea, stomach pain
• Increased hair growth, especially on your face
• Swelling 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