Without a Prescription
Ciclosporin 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 prescribed to avoid long-term rejection in people previously treated with other immunosuppressant drugs, such as Imuran.
Constant monitoring is necessary to prevent toxicity due to overdosing or to prevent possible organ rejection due to underdosing.
If you take Ciclosporin orally over a period of time, your doctor will monitor your blood levels of cyclosporine to make sure your body is receiving the correct amount of Ciclosporin.
It is important to note that Ciclosporin may need to be taken by mouth for an indefinite period following surgery.
Neoral is a newer formulation of Ciclosporin's active ingredient, cyclosporine. In addition to prevention of organ rejection, it is prescribed for certain severe cases of rheumatoid arthritis and psoriasis.
Ciclosporin is always given with prednisone or a similar steroid. It is available in capsules and liquid, or as an injection.
Ciclosporin is sometimes prescribed in the treatment of severe skin disorders, including psoriasis and dermatomyositis (inflammation of the skin and muscles causing weakness and rash).
Some doctors prescribe Ciclosporin to treat alopecia areata (localized areas of hair loss), aplastic anemia (shortage of red and white blood cells and platelets), Crohn's disease (chronic inflammation of the digestive tract), and nephropathy (kidney disease).
The drug is prescribed in procedures involving bone marrow, the pancreas, and the lungs.
The reason for this repeated testing is that the absorption of this drug in the body is erratic.
Ciclosporin side effects that you should report to your health care professional or doctor as soon as possible:
Other common side effects may include:
- Sinus inflammation;
- Or joint pain;
- Numbness or tingling;
- Nasal inflammation;
- Lymph system tumor;
- Liver damage;
- Flu-like symptoms;
- Breathing difficulty;
- Abdominal discomfort;
Less common side effects may include:
- Stomach inflammation;
- Ringing in the ears;
- Rash and other skin disorders;
- Peptic ulcer;
- High blood sugar;
- Hearing loss;
- Frequent urination;
- Fluid retention;
- Conjunctivitis (pinkeye);
- Brittle fingernails;
- Blood disorders;
- Bleeding gums;
- Appetite loss or increase;
- Allergic reactions;
- Abdominal distention;
Rare side effects may include:
- Weight loss;
- Visual disturbance;
- Swallowing difficulty;
- Stomach and upper intestinal bleeding;
- Night sweats;
- Mouth sores;
- Lymph disorders;
- Joint pain;
- Heart attack;
- Hair breaking;
- Chest pain;
- Breast development in males;
- Blood in the urine;
Ciclosporin is contraindicated if you have any of the following conditions:
- If high blood pressure develops while you are taking neoral for transplant rejection;
- If it develops while you are taking the drug for arthritis or psoriasis;
- If you are taking high doses of steroid drugs, particularly methylprednisolone (medrol);
- If you have a kidney condition, high blood pressure, or cancer;
- If you have ever had an allergic reaction to them;
- If you take neoral for arthritis or psoriasis, the condition will eventually return when you stop taking the drug, generally within 1 or 2 months;
- If your body is trying hard to reject a transplanted organ;
Do not take Ciclosporin with any of the following drugs:
- Vancomycin (vancocin);
- Trimethoprim/sulfamethoxazole (bactrim, septra);
- Tobramycin (nebcin);
- Ticlopidine (ticlid);
- Tacrolimus (prograf);
- Saquinavir (fortovase);
- Ritonavir (norvir);
- Rifampin (rifadin, rifamate, rimactane);
- Ranitidine (zantac);
- Quinupristin (synercid);
- Prednisolone (delta-cortef, prelone);
- Potassium-sparing diuretics (dyrenium, midamor, aldactone);
- Phenytoin (dilantin);
- Orlistat (xenical);
- Octreotide (sandostatin);
- Nonsteroidal anti-inflammatory drugs such as clinoril and naprasyn;
- Nafcillin (unipen);
- Metoclopramide (reglan);
- Methylprednisolone (depo-medrol, medrol, solu-medrol);
- Melphalan (alkeran);
- Lovastatin (mevacor);
- Ketoconazole (nizoral);
- Itraconazole (sporanox);
- Indinavir (crixivan);
- Gentamicin (garamycin);
- Fluconazole (diflucan);
- Erythromycin (e.e.s., erythrocin, others);
- Digoxin (lanoxin, lanoxicaps);
- Diclofenac (voltaren, cataflam);
- Danazol (danocrine);
- Clarithromycin (biaxin);
- Cimetidine (tagamet);
- Carbamazepine (tegretol);
- Calcium-blocking heart and blood pressure medications such as calan, cardene, procardia, and cardizem;
- Bromocriptine (parlodel);
- Amphotericin b (fungizone, abelcet);
- Amiodarone (cordarone);
- Allopurinol (zyloprim);
Both drugs have been prescribed to prevent transplant rejection in small children.
Dosage is generally the same for children as for adults, though somewhat higher doses are sometimes needed.
Neoral has not been tested for arthritis or psoriasis in children under 18.
Psoriasis or Rheumatoid Arthritis
Your doctor may gradually increase the daily dose to a maximum of 4 milligrams per 2.2 pounds.
The starting dosage is 2.5 milligrams of Neoral per 2.2 pounds of body weight divided into 2 doses per day.
Your doctor will tailor your dosage of Ciclosporin in accordance with your body's response.
After that, the doctor may keep you on a daily dose of 5 to 10 milligrams per 2.2 pounds of body weight.
Expect a single dose of 15 milligrams per 2.2 pounds of body weight 4 to 12 hours before a transplant and 1 dose daily for 1 to 2 weeks after the operation.
The dosage of Neoral depends on the type of transplant and the other drugs you are taking. It is always taken twice a day.
Although no specific information is available, an overdose of Ciclosporin would be expected to cause liver and kidney problems. Any medication taken in excess can have serious consequences.
If you suspect an overdose of Ciclosporin, seek medical attention immediately.