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Medications > Cyclosporine (Neoral) > Cyclosporine (Neoral) – Detailed Information

CYCLOSPORINE (Neoral®)

What is Cyclosporine?

Cyclosporine is an immunosuppressive medication (suppresses the immune system).  Cyclosporine is used for several different types of rheumatic disease including rheumatoid arthritis, psoriatic arthritis, and other immune disorders of the eyes, lungs, muscles, skin, nerves, and blood vessels.  Traditionally, Cyclosporine has been used in the field of organ transplants.

How does Cyclosporine work?

Cyclosporine works by suppressing the body’s immune system.  Although this suppression can make it slightly harder for you to fight off infections, it also stabilizes the immune system if it is overactive.

How do I take Cyclosporine?

  • Cyclosporine is taken by mouth and is available in 25, 50, & 100 mg capsules and an oral suspension (liquid).
  • The initial dose of Cyclosporine is based on your body weight (2.5 mg/kg/day).
  • Cyclosporine is taken twice daily, 12 hours apart, with or without food.
  • Cyclosporine should not be taken with grapefruit juice as it interferes with the absorption of the medication.

Who should Not take Cyclosporine?

  • Patients who have had a previous serious reaction to Cyclosporine.
  • Women who are pregnant, planning on becoming pregnant, or are breast feeding.
  • Some patients with diseases of the liver or kidney.
  • Patients with uncontrolled high blood pressure.
  • Patients with active uncontrolled infections.
  • Possibly patients with a past history of cancer.
  • Patients with other diseases which affect the immune system (e.g. HIV).

When will I start to feel the effects of Cyclosporine?

Cyclosporine does not work right away.  It will usually take about 3 to 4 months to know if the Cyclosporine is working.

What should I Avoid while taking Cyclosporine?

  • Do not get pregnant or breast feed.
  • You should discuss all vaccinations with your doctor as some vaccines are not advisable while you are taking Cyclosporine.
  • If you are scheduled for surgery, please tell your doctor.

Which Medications are safe to take with Cyclosporine?

There are several prescription medications which can interact with Cyclosporine.  Your doctor should provide you with a list of these medications   When prescribed any new medication, talk to your doctor to ensure it will not interact with your Cyclosporine.  Over the counter medications (cold remedies, pain medication, cough syrup, laxatives, vitamins etc) are not known to interact with Cyclosporine.  Information on herbal medications is less clear.  DO NOT USE ECHINACEA as it appears to increase the risk of kidney side effects.

What are the side-effects of Cyclosporine?

MINOR side-effects include:

  • Nausea, bloating, abdominal cramps, and diarrhea.
  • Fatigue, weakness, muscle cramps, tremors, and flushing.
  • Headaches.
  • Tingling in the fingers, toes, tip of the nose, tongue, or lips.
  • Increased hair growth on the arms, back of the hands, above the lip, or on the side of the face.
  • Tender, swollen, or bleeding gums.
  • Swelling of the ankles (please inform your doctor)

RARE side-effects include:

  • Kidneys – Cyclosporine may affect kidney function.  Kidney function is monitored closely with blood tests while you are taking Cyclosporine.  When monitored closely, any change in kidney function is usually reversible by reducing the dose or stopping the Cyclosporine.
  • High Blood Pressure – Cyclosporine may cause an increase in blood pressure.  If this should happen, the dose of your cyclosporine may be adjusted or a medication to control your blood pressure may be prescribed.
  • Infection – Any infections or fevers should be taken seriously and reviewed by your doctor.
  • Liver – Cyclosporine may irritate the liver.  This does not usually cause symptoms but may be found on blood tests.  It is rare and usually reversible when regularly monitored with your monthly blood tests.
  • Malignancy – When used for long periods of time, Cyclosporine may be associated with a small increased risk of lymphoma and skin cancers.  These cancers may be reversible when the medication is stopped.

How can I help to minimize the side-effects of Cyclosporine?

  • Take your Cyclosporine as prescribed by your doctor, get your blood tests done regularly, and attend all appointments with your doctor.
  • Drink 8 to 10 glasses of water per day (1.5 liters) to help your kidney function.
  • Report any infections to your doctor.

Do I need to have regular blood tests while taking Cyclosporine?

  • YES, you will need BLOOD & URINE TESTS EVERY TWO WEEKS TO EVERY MONTH.  This is important to make sure the Cyclosporine is having no harmful effects on your kidneys or liver.
  • BLOOD PRESSURE should be checked EVERY WEEK FOR THE FIRST MONTH of therapy and then EVERY MONTH THEREAFTER.

How do I stop the Cyclosporine?

You do not need to wean yourself off Cyclosporine.  It can simply be stopped.  However, your disease may “flare” after you stop the medicine.

What should I do if I miss a dose of Cyclosporine?

If you forget to take your Cyclosporine at the usual time but remember later on the same day, skip the dose and take your next scheduled dose.

Is Cyclosporine safe in Pregnancy?

  • Experience with Cyclosporine in pregnancy is limited.  Although there is no current evidence that Cyclosporine causes birth defects or miscarriages it is best to AVOID PREGNANCY while on Cyclosporine.
  • All women of child bearing potential taking Cyclosporine should use reliable contraception.  If you become pregnant while taking Cyclosporine NOTIFY YOUR DOCTOR IMMEDIATELY.
  • You should NOT BREAST FEED as Cyclosporine is transferred through breast milk.