Cyclosporine (Systemic)

Brand Names : Neoral, Sandimmune, SangCya, ciclosporin, cyclosporin A

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For cyclosporine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to cyclosporine.

Pregnancy - Studies have not been done in humans. However, some women who received cyclosporine during pregnancy delivered their babies prematurely, and some babies were smaller than average when they were born. Additionally, some babies had birth defects. It is not certain that these birth defects occurred because of the use of cyclosporine by the mothers.

Studies in rats and rabbits have shown that cyclosporine at toxic doses (2 to 5 times the human dose) causes birth defects or death of the fetus.

Breast-feeding - Cyclosporine passes into breast milk. There is a chance that it could cause the same side effects in the baby that it does in people taking it. It may be necessary for you to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children - This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults - Older people are more likely to experience some side effects (e.g., high blood pressure and kidney problems) than are younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking cyclosporine, it is especially important that your health care professional knows if you are taking any of the following:

• Amiloride (e.g., Midamor) or
• Spironolactone (e.g., Aldactone) or
• Triamterene (e.g., Dyrenium) - Since both cyclosporine and these medicines increase the amount of potassium in the body, potassium levels could become too high

• Allopurinol (e.g., Zyloprim) or
• Androgens (male hormones) or
• Bromocriptine (e.g., Parlodel) or
• Cimetidine (e.g., Tagamet) or
• Clarithromycin (e.g., Biaxin) or
• Danazol (e.g., Danocrine) or
• Diltiazem (e.g., Cardizem) or
• Erythromycins (medicine for infection) or
• Estrogens (female hormones) or
• Fluconazole (e.g., Diflucan) or
• Human immunodeficiency virus (HIV) protease inhibitors (e.g., Crixivan, Fortovase, Invirase, Norvir, Viracept) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Nefazodone (e.g., Serzone) or
• Nicardipine (e.g., Cardene) or
• Verapamil (e.g., Calan, Covera-HS, Isoptin, Verelan) - May increase effects of cyclosporine by increasing the amount of cyclosporine in the body

• Azathioprine (e.g., Imuran) or
• Chlorambucil (e.g., Leukeran) or
• Corticosteroids (cortisone-like medicine) or
• Cyclophosphamide (e.g., Cytoxan) or
• Mercaptopurine (e.g., Purinethol) or
• Muromonab-CD3 (monoclonal antibody) (e.g., Orthoclone OKT3) - There may be an increased risk of infection and cancer because both cyclosporine and these medicines decrease the body's ability to fight them

• Coal tar (e.g., Balnetar, Zetar) or
• Methoxsalen (e.g., Oxsoralen) or
• Radiation therapy or
• Trioxsalen (e.g., Trisoralen) - There may be increased risk of some skin cancers

• Lovastatin (e.g., Mevacor)
• Simvastatin (e.g., Zocor) - May increase the risk of muscle problems and kidney problems

Other medical problems - The presence of other medical problems may affect the use of cyclosporine. Make sure you tell your doctor if you have any other medical problems, especially:

• Cancer or
• Precancerous skin changes - Cyclosporine can make these conditions worse

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• High blood pressure - Cyclosporine can cause high blood pressure

• Hyperkalemia (too much potassium in the blood) - Cyclosporine can make this condition worse

• Infection - Cyclosporine decreases the body's ability to fight infection

• Intestine problems - Effects may be decreased because cyclosporine cannot be absorbed into the body

• Kidney disease - Cyclosporine can have harmful effects on the kidney when it is taken for long periods of time

• Liver disease - Effects of cyclosporine may be increased because of slower removal of the medicine from the body