Cyclosporine (Systemic)

Adult Medication

Brand Names: US

Gengraf; Neoral; SandIMMUNE

Brand Names: Canada

Apo-Cyclosporine; Neoral; Sandimmune I.V.; Sandoz-Cyclosporine

Warning

All products:

  • There is more than 1 brand of this drug. One brand cannot safely be used for the other. The doctor will tell you about any needed change.
  • Have blood work checked as you have been told by the doctor. Talk with the doctor.
  • You may have more chance of getting an infection. Wash hands often. Stay away from people with infections, colds, or flu.
  • This drug may add to your chance of getting lymphoma or other cancers.
  • If this drug is given with other drugs that work on the immune system, it can add to the chance of getting an infection or lymphoma or other cancers. Call your doctor right away if you have a change in color or size of a mole; a lump in the armpit, groin, or neck; or any new or changing skin lump or growth. Talk with the doctor.

Sandimmune®:

  • This drug may be given with steroid drugs like hydrocortisone. Do not use with other drugs that weaken the immune system. Talk with the doctor.

Gengraf® or Neoral®:

  • This drug may cause kidney problems in some patients. Talk with the doctor.
  • This drug may cause high blood pressure.
  • Have your blood pressure checked often. Talk with your doctor.
  • If you are taking this drug for psoriasis AND you have used other drugs or radiation to treat this health problem before, your chance of skin cancer may be higher.

What is this drug used for?

  • It is used to keep the body from harming the organ after an organ transplant.
  • It is used to treat rheumatoid arthritis.
  • It is used to treat very bad psoriasis.
  • It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

For all patients taking this drug:

  • If you have an allergy to cyclosporine or any other part of this drug.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have psoriasis and are using other treatments like other drugs or radiation.
  • If you are taking any of these drugs: Aliskiren, amiloride, bosentan, dabigatran, orlistat, spironolactone, or triamterene.

Psoriasis or rheumatoid arthritis:

  • If you are taking this drug to treat psoriasis or rheumatoid arthritis and you have kidney problems, very high blood pressure, or cancer.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell dentists, surgeons, and other doctors that you use this drug.
  • If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
  • If you are taking a salt substitute that has potassium, potassium-sparing diuretics, or potassium, talk with your doctor.
  • There is a chance of skin cancer. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
  • Have your skin checked often. Talk with your doctor.
  • Some people treated with this drug have had very bad kidney problems caused by a certain viral infection (BK virus). In people who have had a kidney transplant, BK virus infection may cause loss of the kidney. Call your doctor right away if you have signs of kidney problems like change in the amount of urine passed, difficulty or pain when passing urine, or blood in the urine.
  • A very bad and sometimes deadly brain problem called posterior reversible encephalopathy syndrome (PRES) has happened with this drug. Talk with the doctor.
  • Talk with your doctor before getting any vaccines. Use with this drug may either raise the chance of an infection or make the vaccine not work as well.
  • Take good care of your teeth. See a dentist often.
  • Avoid grapefruit and grapefruit juice.
  • You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Use with care in children. Talk with the doctor.
  • This drug may cause harm to the unborn baby if you take it while you are pregnant.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Sandimmune®:

  • This drug may cause high blood pressure.
  • Have your blood pressure checked. Talk with your doctor.
  • This drug has alcohol in it. Talk with the doctor.

Gengraf® or Neoral®:

  • Some products have alcohol in them. Talk with the doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.
  • Signs of bleeding like throwing up blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop.
  • Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • A burning, numbness, or tingling feeling that is not normal.
  • Chest pain or pressure or a fast heartbeat.
  • A heartbeat that does not feel normal.
  • Gum changes.
  • Muscle pain or weakness.
  • Hearing loss.
  • Seizures.
  • Shortness of breath.
  • Shakiness.
  • Swelling.
  • Very bad headache.
  • Change in thinking clearly and with logic.
  • Loss of eyesight. This can be long-lasting.
  • A very bad brain problem called progressive multifocal leukoencephalopathy (PML) may happen with this drug. It may cause disability or death. Tell your doctor right away if you have signs like confusion, memory problems, low mood (depression), change in the way you act, change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or change in eyesight.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
  • Headache.
  • Loose stools (diarrhea).
  • Hair growth.
  • Pimples (acne).
  • Dizziness.
  • Upset stomach or throwing up.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

All products:

  • To gain the most benefit, do not miss doses.
  • Take as you have been told, even if you feel well.
  • Take this drug at the same time of day.

All oral products:

  • Take with or without food. Always take with food or always take on an empty stomach.
  • If you are taking sirolimus, take it 4 hours after taking this drug.

Liquid (solution):

  • Measure liquid doses carefully. Use the measuring device that comes with this drug.
  • Do not rinse the syringe that comes with this drug before or after you take your dose. If you need to wash it, be sure it is completely dry before you use it again.

Gengraf® or Neoral®:

  • Mix solution in glass with orange or apple juice at room temperature and drink it right away. Rinse glass with more liquid and drink.

Sandimmune®:

  • Mix solution in glass with 1 cup of milk, chocolate milk, or orange juice at room temperature and drink it right away. Rinse glass with more juice or milk and drink.

Shot:

  • It is given as an infusion into a vein over a period of time.

What do I do if I miss a dose?

All oral products:

  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

Shot:

  • Call the doctor to find out what to do.

How do I store and/or throw out this drug?

All oral products:

  • Store in the original container at room temperature.
  • Store in a dry place. Do not store in a bathroom.

Liquid (solution):

  • Store at room temperature. Do not refrigerate or freeze.
  • Throw away any part of the solution not used after 2 months.

Shot:

  • This drug will be given to you in a hospital or doctor’s office. You will not store it at home.

All products:

  • Keep all drugs out of the reach of children and pets.
  • Check with your pharmacist about how to throw out unused drugs.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date

2015-04-22

Copyright

© 2015 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved.
If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.
Cyclosporine (Systemic)
©2015 Memorial Sloan Kettering Cancer Center - Generated on July 30, 2015