Gengraf SolutionGeneric Name: Cyclosporine
Examples include Gengraf and Neoral
Gengraf Solution suppresses the immune system, which may increase your risk of developing an infection or cancer. In kidney, liver, or heart transplant patients, Gengraf Solution may be used along with other medicines that suppress the immune system. Using these medicines together may further increase your risk of developing an infection or a certain type of cancer (lymphoma).
Gengraf Solution cannot be switched with other forms of cyclosporine (eg, Sandimmune) without your doctor's approval. If you are taking Gengraf Solution for a transplant or for rheumatoid arthritis, lab tests may be performed to monitor your progress or to check for side effects, such as toxicity.
If you are using Gengraf Solution for psoriasis and you are also using certain other forms of treatment (eg, psoralen ultraviolet A [PUVA] or ultraviolet B [UVB] therapy, medicines that suppress the immune system, coal tar, radiation therapy), you may be at an increased risk of developing skin cancer.
Gengraf Solution may cause high blood pressure or kidney problems. This risk may be increased with high doses or prolonged use of Gengraf Solution. Kidney function tests may be performed while you are taking Gengraf Solution to check for side effects.
Gengraf Solution is used for:
Preventing the rejection of organ transplants (kidney, liver, and heart). Gengraf Solution is also used to treat psoriasis and rheumatoid arthritis in certain patients. It may also be used for other conditions as determined by your doctor.
Gengraf Solution is an immunosuppressant. Exactly how Gengraf Solution works is not known, but it may block certain white blood cells (lymphocytes).
Do NOT use Gengraf Solution if:
- you are allergic to any ingredient in Gengraf Solution
- you are taking bosentan, disulfiram, fluorouracil, metronidazole, orlistat, or a potassium-sparing diuretic (eg, spironolactone)
- you have psoriasis or rheumatoid arthritis and also have kidney problems, uncontrolled high blood pressure, or cancer
- you are using other therapies for psoriasis (eg, PUVA or UVB therapy, methotrexate or other medicines that suppress the immune system, coal tar, radiation therapy)
- you are going to be vaccinated with a live vaccine
Contact your doctor or health care provider right away if any of these apply to you.
Before using Gengraf Solution:
Some medical conditions may interact with Gengraf Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have liver, kidney, brain, or nerve problems; high blood potassium or uric acid levels; low blood magnesium or cholesterol levels; high blood pressure; cancer; an infection; or problems absorbing food or medicine; or have had a recent vaccination
- if your diet contains a lot of potassium
- if you have a history of seizures
- if you are having phototherapy for psoriasis, or are having radiation treatment
Some MEDICINES MAY INTERACT with Gengraf Solution. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Many prescription and nonprescription medicines (eg, used for infections, inflammation, allergic reactions, asthma, aches and pains, high blood pressure, cancer, gout, diabetes, heartburn, high cholesterol, irregular heartbeat or other heart problems, birth control, Parkinson disease, stomach and intestinal problems, endometriosis, HIV, seizures, blood clotting, weight loss, arthritis, psoriasis, depression, sleep, other conditions), multivitamin products, and herbal or dietary supplements (eg, St. John's wort) may interact with Gengraf Solution. They may increase the risk of side effects or decrease the effectiveness of this or other medicines
- Potassium-sparing diuretics (eg, spironolactone) because the risk of high blood potassium levels may be increased
- Bosentan because the risk of its side effects and toxic effects may be increased by Gengraf Solution
- Disulfiram, fluorouracil , or metronidazole because flushing, headache, fast or irregular heartbeat, shortness of breath, nausea, or vomiting may occur
- Orlistat because it may decrease Gengraf Solution's effectiveness
This may not be a complete list of all interactions that may occur. Ask your health care provider if Gengraf Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use Gengraf Solution:
Use Gengraf Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take Gengraf Solution on a regular schedule with regard to food and time of day.
- Do not eat grapefruit or drink grapefruit juice while you use Gengraf Solution.
- If you also take sirolimus, do not take it within 4 hours after taking Gengraf Solution. Check with your doctor if you have questions.
- Follow your doctor's instructions on how to dilute Gengraf Solution. Use a glass container to mix Gengraf Solution. To improve the flavor, Gengraf Solution may be mixed with room temperature orange or apple juice. Certain brands of Gengraf Solution should not be taken with apple juice; check with your doctor or pharmacist.
- Avoid frequently switching the liquid that you use to mix Gengraf Solution in. Stir well and drink right away (do not let it stand before drinking). Rinse glass with more liquid and drink again to make sure the entire dose is taken.
- Do not rinse the dosing syringe with water or other cleaning agents. This will affect the dose. If the syringe needs to be cleaned, it must be completely dry before it is used again.
- If you miss a dose of Gengraf Solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Gengraf Solution.
Important safety information:
- Gengraf Solution may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use Gengraf Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not switch to another doseform or change brands of Gengraf Solution without talking to your doctor. Products made by other companies may not work as well for you.
- Gengraf Solution may increase your risk of skin cancer. Avoid the sun, sunlamps, or tanning booths until you know how you react to Gengraf Solution. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. It may also increase your risk of developing other forms of cancer (eg, lymphoma). Discuss any questions or concerns with your doctor.
- Gengraf Solution may lower the ability of your body to fight infection and may increase the risk of severe infections. Avoid contact with people who have colds or infections. Tell your doctor right away if you notice signs of infection like fever, sore throat, rash, or chills.
- Some people treated with Gengraf Solution have developed severe kidney problems associated with the BK virus infection. Tell your doctor right away if you notice symptoms of kidney problems (eg, change in the amount of urine produced, difficult or painful urination, blood in the urine). In kidney transplant patients, BK virus infection may cause loss of the transplanted kidney. Discuss any questions or concerns with your doctor.
- Do not receive a live vaccine (eg, measles, mumps) while you are taking Gengraf Solution. Talk with your doctor before you receive any vaccine.
- Gengraf Solution may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
- Check with your doctor before you use a salt substitute or a product that has potassium in it.
- Tell your doctor or dentist that you take Gengraf Solution before you receive any medical or dental care, emergency care, or surgery.
- Patients who are being treated for psoriasis will need to have careful skin and physical examinations, including blood pressure measurements, before starting this medication.
- Diabetes patients - Gengraf Solution may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Lab tests, including kidney and liver function; cyclosporine levels; and blood pressure, lipids, and electrolytes, may be performed while you use Gengraf Solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use Gengraf Solution with caution in the ELDERLY; they may be more sensitive to its effects.
- PREGNANCY and BREAST-FEEDING: Gengraf Solution may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Gengraf Solution while you are pregnant. Gengraf Solution is found in breast milk. Do not breast-feed while taking Gengraf Solution.
Possible side effects of Gengraf Solution:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Acne; burning sensation; coughing; dizziness; flushing; headache; increased hair growth; nausea; runny nose; sleeplessness; stomach discomfort; vomiting.Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stools; blood in the urine; change in the appearance of a mole; chest pain; confusion; dark urine; diarrhea; fast or irregular heartbeat; gum disease or overgrowth; increased or decreased urination; loss of coordination; mental or mood changes; muscle cramps; numbness or tingling of the skin; seizures; severe or persistent headache or dizziness; shortness of breath; symptoms of infection (eg, chills, cough, fever, painful urination, sore throat); tremors; unusual bleeding or bruising; unusual lumps; unusual thickening or growth on the skin; unusual tiredness or weakness; vision changes; wheezing; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately.Proper storage of Gengraf Solution:
Store Gengraf Solution at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in the original container. Store away from heat, moisture, and light. Do not refrigerate. Use the contents within 2 months of opening. If stored below 68 degrees F (20 degrees C), the solution may gel or become cloudy. This will not affect the product. If this occurs, bring it to room temperature (77 degrees F [25 degrees C]). Do not store in the bathroom. Keep Gengraf Solution out of the reach of children and away from pets.
- If you have any questions about Gengraf Solution, please talk with your doctor, pharmacist, or other health care provider.
- Gengraf Solution is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
This information is a summary only. It does not contain all information about Gengraf Solution. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.
- Gengraf Prescribing Information (FDA)
- Gengraf Concise Consumer Information (Cerner Multum)
- Gengraf Advanced Consumer (Micromedex) - Includes Dosage Information
- Cyclosporine Prescribing Information (FDA)
- Cyclosporine Detailed Consumer Information (PDR)
- Neoral Prescribing Information (FDA)
- Neoral Detailed Consumer Information (PDR)
- Sandimmune Prescribing Information (FDA)
- cyclosporine Ophthalmic Advanced Consumer (Micromedex) - Includes Dosage Information