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Cyclosporine
Neoral; Sandimmune
Pregnancy Category C
Drug classes
Immunosuppressants
Mechanism of action
Inhibits the activation of T-lymphocytes by inhibition of production
and release of interleukin II.
Indications
- Cyclosporine is used to prevent rejection of kidney, liver, and heart
transplants.
- Severe active rheumatoid arthritis not responding to methotrexate
alone.
- Severe recalcitrant plaque psoriasis.
Contraindications
- Allergy to cyclosporine or any other drugs.
- Concomitant use of the following medications: high doses of corticosteroids,
allopurinol (Zyloprim), azithromycin (Zithromax), bromocriptine (Parlodel),
carbamazepine (Tegretol), cimetidine (Tagamet), clarithromycin (Biaxin),
danazol, diclofenac (Voltaren), diltiazem (Cardizem), dirithromycin (Dynabac),
erythromycin, fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole
(Nizoral), methotrexate, metoclopramide (Reglan), methylprednisolone (Medrol),
octreotide (Sandostatin), phenobarbital, phenytoin (Dilantin), prednisolone,
ranitidine (Zantac), rifabutin (Mycobutin), rifampin (Rifadin), spironolactone
(Aldactone), tacrolimus (Prograf), ticlopidine (Ticlid), triamterene (Dyrenium),
trimethoprim/sulfamethoxazole (Bactrim, Septra), verapamil (Calan), and
vitamins.
- Liver or kidney disease, high blood pressure, low cholesterol, or
low levels of magnesium blood levels.
- Pregnancy, plan to become pregnant, or are breast-feeding.
- Patients must be informed to avoid people with contagious diseases
such as the flu. Keep cuts and scratches clean. They must be instructed
to use good personal hygiene, particularly for your mouth, teeth, skin,
hair, and hands. They must call the doctor immediately if they have signs
of an infection such as fever, sore throat, chills, and frequent and painful
urination.
- Avoid drinking grapefruit juice or eating grapefruit 1 hour before
or 2 hours after taking cyclosporine.

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Adverse effects
- GIT: upset stomach, vomiting,
diarrhea, loss of appetite
- Skin: increased hair growth, jaundice,
overgrowth of gums
- Respiratory: sinusitis
- CNS: confusion, seizures, tremors,
lack of control over body movements, headache.
- Other: breast enlargement , infections,
bleeding tendency, oliguria, edema, visual disturbances.
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