Cyclosporine

Immunosuppressant

Brand names:

Gengraf®, Neoral®, Sandimmune®

Other names:

Cyclosporine A

Often used for:

Graft versus host disease (GVHD) after transplants such as stem cell (bone marrow) transplant; Aplastic Anemia; Rheumatoid arthritis, Psoriasis

What is cyclosporine?

Cyclosporine is a medicine that suppresses the immune system (immunosuppressant). It is used to decrease the body’s natural immune system response and prevent or treat GVHD after stem cell transplant. It is also used to treat aplastic anemia and other bone marrow failure syndromes.

This medicine may be given in the clinic, hospital, or at home. Cyclosporine is usually used along with other medicines.

Your child will have regular blood draws to check potassium and magnesium levels and to monitor kidney and liver function.

Your care team will also measure cyclosporine levels in the blood. The dose may change based on these tests. Your care team will let you know when tests will be performed to measure cyclosporine levels in the blood. On the day of the test, your child should not take the medicine until after the blood sample is collected. If your child has already taken cyclosporine before the lab is drawn, please tell your doctor or pharmacist.

May be given as a capsule by mouth

May be given as a liquid by mouth

May be given into a vein by IV

Possible side effects

Increased risk of infection
High blood pressure
Increased hair on body and face
Increased growth of gums (gingival hyperplasia)
High blood potassium levels
Decreased kidney function
Tremors (shaking of the body)
Nausea and vomiting
Stomach or abdominal pain
Loss of appetite
Diarrhea
Headache
Dizziness

Numbness or tingling in hands and feet
Acne
Flushed skin or sudden redness in the face, neck, or chest
Seizures (rare)
High blood sugar levels
Low blood magnesium levels
Decreased liver function

Not all patients who take cyclosporine will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist. Find more information on side effects.

Possible long-term or late effects

Patients who take immunosuppressants like cyclosporine may be at risk for medical problems later in life. These can include second cancers (such as lymphoma or skin cancer). Your care team can give you more information about your child’s risk.

Tips for patients and families

Be sure to discuss all questions and instructions with your doctor or pharmacist.

While taking cyclosporine, your child should drink plenty of fluids. Follow your care team’s instructions about how much fluid to drink.
While taking this medicine, your child should not eat grapefruit or Seville (bitter) oranges or drink juice or beverages containing grapefruit or Seville orange.
Do not switch brands of cyclosporine unless your doctor tells you to do so.
Some medicines may change the blood level of cyclosporine, increase its side effects, or change how well it works. These medicines include: erythromycin, ketoconazole, fluconazole, fluoxetine, itraconazole, metoclopramide, methylprednisolone, rifampin, clarithromycin, carbamazepine, omeprazole, phenytoin, phenobarbital, potassium-sparing diuretics, digoxin, verapamil, and diltiazem. Always tell your doctor and pharmacist about all medicines your child takes.
This medicine may cause extra tissue to grow on the gums, so patients must brush their teeth daily and get regular dental check-ups.
It is important that patients tell the care team if they are sexually active, pregnant, or breastfeeding.
Sexually active patients should take steps to prevent pregnancy while taking cyclosporine and for 6 months after treatment is complete.

Cyclosporine at home:

Cyclosporine can be taken with or without food. Take with food if stomach upset occurs. Taking the medicine with meals may lessen stomach problems.
It is important to take this medicine the same way every day. Taking the medicine at the same time each day and at the same time in relation to meals will help keep the same amount of cyclosporine in the body.
Capsules: Swallow the capsules whole. Do not cut, crush, or chew capsules.
Liquid: Use the measuring device that comes with the medicine.
To help liquid cyclosporine taste better, mix with room-temperature orange juice or apple juice in a glass container and stir well. Give the medicine right away. Then add a little more juice to the glass, swish it around, and have your child drink it. Never give cyclosporine with grapefruit juice. Check the ingredient label of juices and other drinks before giving them to your child.
If vomiting happens within 30 minutes of taking cyclosporine by mouth, another dose should be given.
If a dose is missed, take the missed dose as soon as possible. If it is near the time of the next dose (within 4 hours), skip the missed dose. Do not give 2 doses at the same time.
Store cyclosporine at room temperature.
Do not use the medicine past the expiration date.
This medicine can pose a health risk to caregivers or others who come in contact with the medicine. Follow instructions for safe handling, storage, and disposal. Keep all medicines out of the reach of children and pets.

Learn more about cyclosporine

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency.

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.

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