Cyclosporine (oral/injection)

Cyclosporine lowers your body's immune system activity to help prevent it from "rejecting" a transplanted organ like a kidney. Organ rejection occurs when the immune system sees the new organ as a threat and attacks it.

Cyclosporine is used to stop organ rejection after a kidney, heart, or liver transplant.

Cyclosporine is also used to treat severe psoriasis or severe rheumatoid arthritis.

Cyclosporine might also be used for reasons that are not mentioned in this medication guide.

You may not be able to use cyclosporine if you have certain medical conditions, are taking certain medicines, or are receiving phototherapy or radiation treatments. MAKE SURE ALL DOCTORS INVOLVED IN YOUR CARE KNOW YOU ARE USING CYCLOSPORINE.

Cyclosporine may increase your risk of serious infections, cancer, or transplant failure. Talk with your doctor about the risks and benefits of using this medication.

You should not use cyclosporine if you are allergic to it. You may not be able to use cyclosporine if you have:

• kidney disease;
• untreated or uncontrolled high blood pressure; or
• any type of cancer.

If you are being treated for psoriasis, you should not receive ultraviolet light therapy (PUVA or UVB), radiation treatments, coal tar, or drugs that weaken the immune system (such as methotrexate) while you are receiving cyclosporine.

Cyclosporine affects your immune system and may cause certain white blood cells to grow uncontrollably. This can lead to cancer, a severe brain infection that could cause disability or death, or a viral infection that could cause kidney transplant failure. Talk with your doctor about the risks of using cyclosporine.

MAKE SURE ALL DOCTORS INVOLVED IN YOUR CARE KNOW YOU ARE USING CYCLOSPORINE.

Tell your doctor if you have ever had:

• liver or kidney disease;
• high blood pressure; or
• if you are scheduled to receive any vaccine.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while you are using cyclosporine.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Cyclosporine may cause serious side effects. Call your doctor right away if you have:

• problems with speech, thinking, vision, or muscle movement (may start gradually and get worse quickly);
• a seizure;
• severe headache, blurred vision, pounding in your neck or ears;
• pale skin, easy bruising, unusual bleeding;
• high potassium level—nausea, weakness, tingling sensation, chest pain, irregular heartbeats, loss of movement;
• kidney problems—urinating less, swelling in your feet or ankles, feeling tired or short of breath;
• liver problems—loss of appetite, stomach pain (upper right side), jaundice (yellowing of the skin or eyes); or
• signs of infection—fever, chills, flu symptoms, mouth sores, skin sores, sore throat, cough, difficulty breathing.

Common side effects of cyclosporine may include:

• tremors or shaking;
• acne, increased growth of facial or body hair;
• increased blood pressure;
• nausea, diarrhea; or
• swollen or painful gums.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Cyclosporine oral is taken by mouth.

Cyclosporine injection is given in a vein if you are unable to take the medicine by mouth.

You may take oral cyclosporine with or without food, but take it the same way each time. Take the medicine at the same time each day.

Measure liquid medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).

Sandimmune oral solution may be mixed with milk, chocolate milk, or orange juice at room temperature to make the medicine taste better. Neoral "modified" (microemulsion) oral solution should be mixed with orange juice or apple juice that is at room temperature.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the form and strength your doctor prescribes.

Use all medications as directed and read all medication guides you receive. Do not change your dose or dosing schedule without your doctor's advice.

You will need frequent medical tests. You must remain under the care of a doctor while you are using cyclosporine.

Store at room temperature away from moisture and heat.

Take the medicine as soon as you remember, but skip the missed dose if it is almost time for your next dose. Do not take two doses at the same time.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222.

Grapefruit can interact with cyclosporine and cause unwanted side effects. Stay away from grapefruit products.

Do not drink alcohol.

Do not get a "live" vaccine. The vaccine may not work as effectively while you are using cyclosporine. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, and varicella (chickenpox).

Avoid close contact with people who are sick or have infections. Tell your doctor immediately if you notice any signs of infection.

Sometimes it is not safe to use certain medications together. Some drugs can change the levels of other drugs in your blood, which may increase side effects or reduce how well the medications work.

Cyclosporine can damage your kidneys, especially if you are also taking certain medicines for infections, cancer, osteoporosis, preventing organ transplant rejection, bowel disorders, high blood pressure, or pain or arthritis (including Advil, Motrin, and Aleve).

Many drugs can affect cyclosporine. This includes both prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you are using.