cyclosporine (oral/injection)

What is the most important information I should know about cyclosporine?

What is cyclosporine?

Cyclosporine weakens your body's immune system, to help keep it from "rejecting" a transplanted organ such as a kidney. Organ rejection happens when the immune system treats the new organ as an invader and attacks it.

Cyclosporine is used to prevent organ rejection after a kidney, heart, or liver transplant.

Cyclosporine is also used to treat severe psoriasis or severe rheumatoid arthritis.

Cyclosporine may also be used for purposes not listed in this medication guide.

What should I discuss with my health care provider before using cyclosporine?

• kidney disease;
• untreated or uncontrolled high blood pressure; or
• any type of cancer.

If you are being treated for psoriasis, you should not receive ultraviolet light therapy (PUVA or UVB), radiation treatments, coal tar, or drugs that weaken the immune system (such as methotrexate) while you are receiving cyclosporine.

MAKE SURE ALL DOCTORS INVOLVED IN YOUR CARE KNOW YOU ARE USING CYCLOSPORINE.

Tell your doctor if you have ever had:

• liver or kidney disease;
• high blood pressure; or
• if you are scheduled to receive any vaccine.

How should I use cyclosporine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Cyclosporine oral is taken by mouth.

Cyclosporine injection is given in a vein if you are unable to take the medicine by mouth.

You may take oral cyclosporine with or without food, but take it the same way each time. Take the medicine at the same time each day.

Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).

Sandimmune oral solution may be mixed with milk, chocolate milk, or orange juice at room temperature to make the medicine taste better. Neoral "modified" (microemulsion) oral solution should be mixed with orange juice or apple juice that is at room temperature.

Use all medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice.

You will need frequent medical tests. You must remain under the care of a doctor while you are using cyclosporine.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

What should I avoid while using cyclosporine?

Grapefruit may interact with cyclosporine and lead to unwanted side effects. Avoid the use of grapefruit products.

Avoid receiving a "live" vaccine. The vaccine may not work as well while you are using cyclosporine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), and zoster (shingles).

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

What are the possible side effects of cyclosporine?

• problems with speech, thought, vision, or muscle movement (may start gradually and get worse quickly);
• a seizure;
• severe headache, blurred vision, pounding in your neck or ears;
• pale skin, easy bruising, unusual bleeding;
• high potassium level --nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement;
• kidney problems --urinating less, swelling in your feet or ankles, feeling tired or short of breath;
• liver problems --loss of appetite, stomach pain (upper right side), jaundice (yellowing of the skin or eyes); or
• signs of infection --fever, chills, flu symptoms, mouth sores, skin sores, sore throat, cough, trouble breathing.

Common side effects may include:

• tremors or shaking;
• acne, increased growth of facial or body hair;
• increased blood pressure;
• nausea, diarrhea; or
• swollen or painful gums.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect cyclosporine?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Cyclosporine can harm your kidneys, especially if you also use certain medicines for infections, cancer, osteoporosis, organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve).

Many drugs can affect cyclosporine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

Where can I get more information?

Your pharmacist can provide more information about cyclosporine.