CYCLOSPORINE

Brand & Generic Names

Sandimmune

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? No
• Drug class: Immunosuppressant

Uses

• Suppresses the immune response in patients who have transplants of the heart, lung, kidney, liver, pancreas. Cyclosporine treats rejection as well as helps prevent it.
• Treatment for severe psoriasis when regular treatment is ineffective or not appropriate.

Dosage & Usage Information

How to take:
Oral solution--Take after meals with liquid to decrease stomach irritation. May mix with milk, chocolate milk or orange juice. Don't mix in styrofoam cups. Use special dropper for exact dosage.
Capsules--Take with water or other fluid. Don't break capsule open.

When to take:
At the same time each day, according to instructions on prescription label.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Exact mechanism is unknown, but believed to inhibit interluken II to affect T-lymphocytes.

Time lapse before drug works:
3 to 3-1/2 hours.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Irregular heartbeat, seizures, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Seizures, wheezing Discontinue. Seek with shortness of emergency treatment. breath, convulsions.

Common:

• Gum inflammation, blood in urine, jaundice, tremors.
• Increased hair growth.

Infrequent:

• Fever, chills, sore throat, shortness of breath.
• Frequent urination, headache, leg cramps.

Rare:

• Confusion, irregular heartbeat, numbness of hands and feet, nervousness, face flushing, severe abdominal pain, weakness.
• Acne, headache.

Warnings & Precautions

Don't take if:

• You have chicken pox.
• You have shingles (herpes zoster).

Before you start, consult your doctor:

• If you have liver problems.
• If you have an infection.
• If you have kidney disease.

Over age 60:
No special problems expected.

Pregnancy:
Safety not established. Consult your doctor.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
No problems expected.

Prolonged use:

• Can cause reduced function of kidney.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, kidney function, liver function.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes.

Discontinuing:
Don't discontinue without consulting doctor. You probably will require this medicine for the remainder of your life.

Others:

• Request regular laboratory studies to measure levels of potassium, cyclosporine in blood, and to evaluate liver and kidney function.
• Check blood pressure. Cyclosporine sometimes causes hypertension.
• Don't store solution in the refrigerator.
• Avoid any immunizations except those specifically recommended by your doctor.
• Maintain good dental hygiene. Cyclosporine can cause gum problems.
• Kidney toxicity occurs commonly after 12 months of taking cyclosporine.
• Don't mix in styrofoam cups.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Androgens	Increased effect of cyclosporine.
Anticonvulsants*	Decreased effect of cyclosporine.
Cimetidine	Increased effect of cyclosporine.
Danazol	Increased effect of cyclosporine.
Diltiazem	Increased effect of cyclosporine.
Diuretics,	Increased effect of cyclosporine.
Erythromycin	Increased effect of cyclosporine.
Estrogens	Increased effect of cyclosporine.
Fluconazole	Increased effect of cyclosporine.
	Cyclosporine dosage must be
	adjusted.
Immuno-	May increase risk of
suppressants*	infection.
Itraconazole	Increased cyclosporine toxicity.
Ketoconazole	Increased risk of toxicity to
	kidney.
Lovastatin	Increased heart and kidney damage.
Medicines that	Increased risk of
may be toxic to	toxicity to kidneys.
Nimodipine	Increased cyclosporine toxicity.
Rifampin	Decreased effect of cyclosporine.
Tiopronin	Increased risk of toxicity to
	kidneys.
Vancomycin	Increased chance of hearing loss or
	kidney damage.
Virus vaccines	Increased adverse reactions to
	vaccine.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	May increase possibility of toxic
	effects. Avoid.
Beverages:	None expected.
Cocaine:	May increase possibility of toxic
	effects. Avoid.
Foods:	None expected.
Marijuana:	May increase possibility of toxic
	effects. Avoid.
Tobacco:	May increase possibility of toxic
	effects. Avoid.