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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

  1. Cyclosporine is used to prevent rejection of kidney, liver, and heart transplants.
  2. Severe active rheumatoid arthritis not responding to methotrexate alone.
  3. 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.

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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