Cyclosporine is given after organ transplant surgery to help prevent rejection of organs (kidney, heart, or liver) by holding down the body's immune system. It is also used to avoid long-term rejection in people previously treated with other immunosuppressant drugs.
In addition to prevention of organ rejection, some brands of cyclosporine are prescribed for certain severe cases of rheumatoid arthritis and psoriasis.
Cyclosporine is available in capsules and liquid, or as an injection.
If you take cyclosporine orally over a period of time, your doctor will monitor your blood levels to make sure your body is receiving the correct amount. The reason for this repeated testing is that the absorption of Cyclosporine in the body is erratic. Constant monitoring is necessary to prevent toxicity due to overdosing or to prevent possible organ rejection due to underdosing. It is important to note that cyclosporine may need to be taken by mouth for an indefinite period following surgery.
Take the cyclosporine capsule or oral liquid at the same time every day. You may take the medication either with a meal or between meals, but be consistent.
To make cyclosporine oral liquid more palatable, you may mix it with certain room-temperature beverages; check with your doctor or pharmacist about which beverages are best for mixing. Use a container made of glass, not plastic. Never let the mixture stand; drink it as soon as you prepare it. To make sure you get your full dose, rinse the glass with a little more liquid and drink that too.
You should maintain good dental hygiene and see your dentist frequently for cleaning to prevent tenderness, bleeding, and gum enlargement.
After you use the dosage syringe to transfer the oral solution to a glass, dry the outside of the syringe with a clean towel and put it away. Do not rinse or wash it. If you do have to clean it, make sure it is thoroughly dry before you use it again.
You may notice an odor when you open the capsule container; this is nothing to worry about and will soon dissipate.
Side effects cannot be anticipated. If any appear or change in intensity, inform your doctor immediately. Only your doctor can determine if it is safe for you to continue taking cyclosporine. The principal side effects of cyclosporine are high blood pressure, hirsutism (unusual growth of hair), kidney damage, excessive growth of the gums, and tremor.
Do not take cyclosporine if you have ever had an allergic reaction to it. Avoid taking cyclosporine for arthritis or psoriasis if you have a kidney condition, high blood pressure, or cancer. While taking the drug, you should avoid most other psoriasis treatments, including ultraviolet light, coal tar, methotrexate, and radiation.
When your immune system is suppressed by cyclosporine, you are at increased risk of infection and of certain malignancies, including skin cancer and lymph system cancer.
High-dose cyclosporine is toxic to the liver and kidneys and may cause serious kidney damage. Because this toxicity has symptoms similar to those of transplant rejection, you must be monitored closely. If your body is trying hard to reject a transplanted organ, your doctor will probably allow the rejection to occur rather than give you a very high dose of cyclosporine.
This drug can raise blood pressure, especially in older people.
Brain disorders have developed in patients taking Cyclosporine, sometimes leading to convulsions, loss of movement, vision problems, impaired consciousness, and psychiatric disturbances. The chance of convulsions is greater if you are taking high doses of steroid drugs, particularly methylprednisolone. Brain-related disorders usually clear up once cyclosporine is discontinued.
Use a barrier method of contraception, such as diaphragms or condoms, during cyclosporine therapy. Do not use oral contraceptive pills without your doctor's approval.
Do not try to change dosage forms without consulting your doctor.
Avoid getting immunizations while you are taking cyclosporine. The drug may make vaccinations less effective or increase your risk of contracting an illness from a live vaccine.
If taking cyclosporine for psoriasis, remember to avoid other psoriasis treatments.
Avoid grapefruit and grapefruit juice while taking Cyclosporine. Also avoid the antidepressant herb St. John's wort. This over-the-counter herbal remedy reduces the effect of cyclosporine and can lead to organ rejection.
If cyclosporine is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining cyclosporine with the following:
AllopurinolAmiodaroneAmphotericin BAtorvastatinBromocriptineCalcium-blocking heart and blood pressure medicationsCarbamazepineCimetidineClarithromycinColchicineDanazolDiclofenacDigoxinErythromycinFluconazoleFluvastatinGentamicinIndinavirItraconazoleKetoconazoleLovastatinMelphalanMethotrexateMethylprednisoloneMetoclopramideNafcillinNelfinavirNonsteroidal anti-inflammatory drugsOctreotideOrlistatPhenobarbitalPhenytoinPotassium-sparing diureticsPravastatinPrednisoloneQuinupristinRanitidineRifampinRitonavirSaquinavirSimvastatinTiclopidineTacrolimusTobramycinTrimethoprim/sulfamethoxazoleVancomycin
The effects of cyclosporine in pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Cyclosporine should be used during pregnancy only if the benefit justifies the potential risk to the unborn child. Since cyclosporine appears in breast milk, it should not be used during breastfeeding.
Your doctor will tailor the dosage based on your weight, how your body responds, and what other drugs you are taking.
Dosage is generally the same for children as for adults, though somewhat higher doses are sometimes needed. Cyclosporine has been used to prevent transplant rejection in small children. It has not, however, been tested for arthritis or psoriasis in children under 18.
Although no specific information is available, an overdose of cyclosporine would be expected to cause liver and kidney problems. Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.