Also found in: Dictionary.
Related to Sandimmune: Altoprev


Apo-Cyclosporine (CA), Gengraf, Neoral, Sandimmune, Sandoz Cyclosporine

cyclosporine ophthalmic emulsion

Restasis, Sandimmun (UK)

Pharmacologic class: Polypeptide antibiotic

Therapeutic class: Immunosuppressant

Pregnancy risk category C

Respiratory: cough, dyspnea, Pneumocystis jiroveci pneumonia, bronchospasm

FDA Box Warning

• Drug should be prescribed only by physicians experienced in managing systemic immunosuppressive therapy for indicated disease. At doses used for solid-organ transplantation, it should be prescribed only by physicians experienced in immunosuppressive therapy and management of organ transplant recipients. Patient should be managed in facility with adequate laboratory and medical resources. Physician responsible for maintenance therapy should have complete information needed for patient follow-up.

• Neoral may increase susceptibility to infection and neoplasia. In kidney, liver, and heart transplant patients, drug may be given with other immunosuppressants.

• Sandimmune should be given with adrenal corticosteroids but not other immunosuppressants. In transplant patients, increased susceptibility to infection and development of lymphoma and other neoplasms may result from increased immunosuppression.

• Sandimmune and Neoral aren't bioequivalent. Don't use interchangeably without physician supervision.

• In patients receiving Sandimmune soft-gelatin capsules and oral solution, monitor at repeated intervals (due to erratic absorption).


Unclear. Thought to act by specific, reversible inhibition of immunocompetent lymphocytes in G0-G1 phase of cell cycle. Preferentially inhibits T lymphocytes; also inhibits lymphokine production. Ophthalmic action is unknown.


Capsules: 25 mg, 100 mg

Injection: 50 mg/ml

Oral solution: 100 mg/ml

Solution (ophthalmic): 0.05% (0.4 ml in 0.9 ml single-use vial)

Indications and dosages


Adults: Neoral only-1.25 mg/kg P.O. b.i.d. for 4 weeks. Based on patient response, may increase by 0.5 mg/kg/day once q 2 weeks, to a maximum dosage of 4 mg/kg/day.

Severe active rheumatoid arthritis

Adults: Neoral only-1.25 mg/kg P.O. b.i.d. May adjust dosage by 0.5 to 0.75 mg/kg/day after 8 weeks and again after 12 weeks, to a maximum dosage of 4 mg/kg/day. If no response occurs after 16 weeks, discontinue therapy. Gengraf only-2.5 mg/kg P.O. daily given in two divided doses; after 8 weeks, may increase to a maximum dosage of 4 mg/kg/day.

To prevent organ rejection in kidney, liver, or heart transplantation

Adults and children: Sandimmune only-Initially, 15 mg/kg P.O. 4 to 12 hours before transplantation, then daily for 1 to 2 weeks postoperatively. Reduce dosage by 5% weekly to a maintenance level of 5 to 10 mg/kg/day. Or 5 to 6 mg/kg I.V. as a continuous infusion 4 to 12 hours before transplantation.

To increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca

Adults: 1 drop in each eye b.i.d. given 12 hours apart

Off-label uses

• Aplastic anemia

• Atopic dermatitis


• Hypersensitivity to drug and any ophthalmic components

• Rheumatoid arthritis, psoriasis in patients with abnormal renal function, uncontrolled hypertension, cancer (Gengraf, Neoral)

• Active ocular infections (ophthalmic use)


Use cautiously in:

• hepatic impairment, renal dysfunction, active infection, hypertension

• herpes keratitis (ophthalmic use)

• pregnant or breastfeeding patients

• children younger than age 16 (safety and efficacy not established for ophthalmic use).


• For I.V. infusion, dilute as ordered with dextrose 5% in water or 0.9% normal saline solution. Administer over 2 to 6 hours.

• Mix Neoral solution with orange juice or apple juice to improve its taste.

• Dilute Sandimmune oral solution with milk, chocolate milk, or orange juice. Be aware that grapefruit and grapefruit juice affect drug metabolism.

• In postoperative patients, switch to P.O. dosage as tolerance allows.

• Be aware that Sandimmune and Neoral aren't bioequivalent. Don't use interchangeably.

• Before administering eyedrops, invert unit-dose vial a few times to obtain a uniform, white, opaque emulsion.

• Know that eyedrops can be used concomitantly with artificial tears, allowing a 15-minute interval between products.

Adverse reactions

CNS: tremor, headache, confusion, paresthesia, insomnia, anxiety, depression, lethargy, weakness

CV: hypertension, chest pain, myocardial infarction

EENT: visual disturbances, hearing loss, tinnitus, rhinitis; (with ophthalmic use) ocular burning, conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, itching, stinging, blurring

GI: nausea, vomiting, diarrhea, constipation, abdominal discomfort, gastritis, peptic ulcer, mouth sores, difficulty swallowing, anorexia, upper GI bleeding, pancreatitis

GU: gynecomastia, hematuria, nephrotoxicity, renal dysfunction, glomerular capillary thrombosis Hematologic: anemia, leukopenia, thrombocytopenia

Metabolic: hyperglycemia, hypomagnesemia, hyperuricemia, hyperkalemia, metabolic acidosis

Musculoskeletal: muscle and joint pain

Respiratory: cough, dyspnea, Pneumocystis jiroveci pneumonia, bronchospasm

Skin: acne, hirsutism, brittle fingernails, hair breakage, night sweats

Other: gum hyperplasia, flulike symptoms, edema, fever, weight loss, hiccups, anaphylaxis


The following interactions pertain to oral and I.V. routes only.

Drug-drug. Acyclovir, aminoglycosides, amphotericin B, cimetidine, diclofenac, gentamicin, ketoconazole, melphalan, naproxen, ranitidine, sulindac, sulfamethoxazole, tacrolimus, tobramycin, trimethoprim, vancomycin: increased risk of nephrotoxicity

Allopurinol, amiodarone, bromocriptine, clarithromycin, colchicine, danazol, diltiazem, erythromycin, fluconazole, imipenem and cilastatin, itraconazole, ketoconazole, methylprednisolone, nicardipine, prednisolone, quinupristin/dalfopristin, verapamil: increased cyclosporine blood level

Azathioprine, corticosteroids, cyclophosphamide: increased immunosuppression Carbamazepine, isoniazid, nafcillin, octreotide, orlistat, phenobarbital, phenytoin, rifabutin, rifampin, ticlopidine: decreased cyclosporine blood level

Digoxin: decreased digoxin clearance

Live-virus vaccines: decreased antibody response to vaccine

Lovastatin: decreased lovastatin clearance, increased risk of myopathy and rhabdomyolysis

Potassium-sparing diuretics: increased risk of hyperkalemia

Drug-diagnostic tests. Alanine aminotransferase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, glucose, low-density lipoproteins: increased levels

Hemoglobin, platelets, white blood cells: decreased values

Drug-food. Grapefruit, grapefruit juice: decreased cyclosporine metabolism, increased cyclosporine blood level

High-fat diet: decreased drug absorption (Neoral)

Drug-herbs. Alfalfa sprouts, astragalus, echinacea, licorice: interference with immunosuppressant action St. John's wort: reduced cyclosporine blood level, possibly leading to organ rejection

Patient monitoring

• Observe patient for first 30 to 60 minutes of infusion. Monitor frequently thereafter.

• Monitor cyclosporine blood level, electrolyte levels, and liver and kidney function test results.

• Assess for signs and symptoms of hyperkalemia in patients receiving concurrent potassium-sparing diuretic.

Patient teaching

• Advise patient to dilute Neoral oral solution with orange or apple juice (preferably at room temperature) to improve its flavor.

• Instruct patient to use glass container when taking oral solution. Tell him not to let solution stand before drinking, to stir solution well and then drink all at once, and to rinse glass with same liquid and then drink again to ensure that he takes entire dose.

• Tell patient taking Neoral to avoid high-fat meals, grapefruit, and grapefruit juice.

• Advise patient to dilute Sandimmune oral solution with milk, chocolate milk, or orange juice to improve its flavor.

• Instruct patient to invert vial a few times to obtain a uniform, white, opaque emulsion before using eyedrops and to discard vial immediately after use.

• Inform patient that eyedrops can be used with artificial tears but to allow 15-minute interval between products.

• Caution patient not to wear contact lenses because of decreased tear production; however, if contact lenses are used, advise patient to remove them before administering eyedrops and to reinsert 15 minutes after administration.

• Inform patient that he's at increased risk for infection. Caution him to avoid crowds and exposure to illness.

• Instruct patient not to take potassium supplements, herbal products, or dietary supplements without consulting prescriber.

• Tell patient he'll need to undergo repeated laboratory testing during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


(sye-kloe-spor-een) ,


(trade name),


(trade name),


(trade name)


Therapeutic: immunosuppressants
Pharmacologic: polypeptides
Pregnancy Category: C
†See for ophthalmic use


Oral: Intravenous: Prevention and treatment of rejection in renal, cardiac, and hepatic transplantation (with corticosteroids). Oral: Treatment of severe active rheumatoid arthritis (Neoral only).Treatment of severe recalcitrant psoriasis in adult nonimmunocompromised patients (Neoral only).Management of recalcitrant ulcerative colitis.Treatment of steroid-resistant nephrotic syndrome.Treatment of severe steroid-resistant autoimmune disease.Prevention and treatment of graft vs. host disease in bone marrow transplant patients.


Inhibits normal immune responses (cellular and humoral) by inhibiting interleukin-2, a factor necessary for initiation of T-cell activity.

Therapeutic effects

Prevention of rejection reactions.
Slowed progression of rheumatoid arthritis or psoriasis.


Absorption: Erratically absorbed (range 10–60%) after oral administration, with significant first-pass metabolism by the liver. Microemulsion (Neoral) has better bioavailability.
Distribution: Widely distributed, mainly into extracellular fluid and blood cells. Crosses the placenta; enters breast milk.
Protein Binding: 90–98%.
Metabolism and Excretion: Extensively metabolized by the liver by CYP3A4 (first pass); excreted in bile, small amounts excreted unchanged in urine.
Half-life: Children—7 hr; adults—19 hr.

Time/action profile (blood levels)

POunknown†2–6 hrunknown
IVunknownend of infusionunknown
†Onset of action in rheumatoid arthritis is 4–8 wk and may last 4 wk after discontinuation; for psoriasis, onset is 2–6 wk and lasts 6 wk following discontinuation


Contraindicated in: Hypersensitivity to cyclosporine or polyoxyethylated castor oil (vehicle for IV form); Obstetric / Lactation: Should not be given unless benefits outweigh risks;Disulfiram therapy or known alcohol intolerance (IV and oral liquid dose forms contain alcohol);Psoriasis patients receiving immunosuppressants or radiation;Renal impairment (in patients with rheumatoid arthritis or psoriasis)Uncontrolled hypertension.
Use Cautiously in: Severe hepatic impairment (dose ↓ recommended);Renal impairment (frequent dose changes may be necessary);Active infection; Pediatric: Larger or more frequent doses may be required.

Adverse Reactions/Side Effects

Central nervous system

  • posterior reversible encephalopathy syndrome (life-threatening)
  • progressive multifocal leukoencephalopathy (life-threatening)
  • seizures (life-threatening)
  • tremor (most frequent)
  • confusion
  • flushing
  • headache
  • psychiatric problems


  • hypertension (most frequent)


  • hepatotoxicity (life-threatening)
  • diarrhea (most frequent)
  • nausea (most frequent)
  • vomiting (most frequent)
  • abdominal discomfort
  • anorexia
  • pancreatitis


  • nephrotoxicity (most frequent)


  • hirsutism (most frequent)
  • acne
  • psoriasis

Fluid and Electrolyte

  • hyperkalemia
  • hypomagnesemia


  • anemia
  • leukopenia
  • thrombocytopenia


  • hyperlipidemia
  • hyperuricemia


  • hyperesthesia
  • paresthesia


  • gingival hyperplasia (most frequent)
  • hypersensitivity reactions (most frequent)
  • infections (including activation of latent viral infections such as BK virus-associated nephropathy) (most frequent)
  • malignancy


Drug-Drug interaction

Azithromycin,clarithomycin, allopurinol, amiodarone, bromocriptine, colchicine, danazol, digoxin, diltiazem, erythromycin, fluconazole, fluoroquinolones, imatinib, itraconazole, ketoconazole, voriconazole, metoclopramide, methylprednisolone, nefazodone, nicardipine, protease inhibitors, quinupristin/dalfopristin, verapamil, boceprevir, telaprevir, or hormonal contraceptives may ↑ serum levels and risk of toxicity.↑ immunosuppression with other immunosuppressants (cyclophosphamide, azathioprine, corticosteroids).Bosentan, carbamazepine, nafcillin, octreotide, orlistat, oxcarbazepine, phenobarbital, phenytoin, rifampin, rifabutin, or terbinafine, or ticlopidine may ↓ levels and effect.↑ risk of hyperkalemia with potassium-sparing diuretics, potassium supplements, or ACE inhibitors.May ↑ serum levels and risk of toxicity of aliskiren, ambrisentan, bosentan, colchicine, digoxin, etoposide, HMG-CoA reductase inhibitors, methotrexate, nifedipine, repaglinide, sirolimus May ↓ antibody response to live-virus vaccines and ↑ risk of adverse reactions; avoid concurrent use.Concurrent use with tacrolimus should be avoided.↑ risk of renal dysfunction with ciprofloxacin, aminoglycosides, vancomycin, trimethoprim/sulfamethoxazole, melphalan, amphotericin B, ketoconazole, colchicine, NSAIDS, cimetidine, ranitidine, or fibric acid derivatives Concomitant use with echinacea and melatonin may interfere with immunosuppression.Use with St. John’s wort may cause ↓ serum levels and organ rejection for transplant patients.Concurrent ingestion of grapefruit or grapefruit juice may ↑serum levels and should be avoided.Food ↓ absorption of microemulsion products (Neoral).


Doses are adjusted on the basis of serum level monitoringPrevention of Transplant Rejection (Sandimmune)
Oral (Adults and Children) 14–18 mg/kg/dose 4–12 hr before transplant then 5–15 mg/kg/day divided q 12–24 hr postoperatively, taper by 5% weekly to maintenance dose of 3–10 mg/kg/day.
Intravenous (Adults and Children) 5–6 mg/kg/dose 4–12 hr before transplant, then 2–10 mg/kg/day in divided doses q 8–24 hr; change to PO as soon as possible.
Prevention of Transplant Rejection (Neoral)
Oral (Adults and Children) 4–12 mg/kg/day divided q 12 hr (dose varies depending on organ transplanted).
Rheumatoid Arthritis (Neoral only)
Oral (Adults and Children) 2.5 mg/kg/day given in 2 divided doses; may ↑ by 0.5–0.75 mg/kg/day after 8 and 12 wk, up to 4 mg/kg/day. ↓ dose by 25–50% if adverse reactions occur.
Severe Psoriasis (Neoral only)
Oral (Adults) 2.5 mg/kg/day given in 2 divided doses, for at least 4 wk; then may ↑ by 0.5 mg/kg/day q 2 wk, up to 4 mg/kg/day. ↓ dose by 25–50% if adverse reactions occur.
Autoimmune Diseases (Neoral only)
Oral (Adults and Children) 1–3 mg/kg/day.

Availability (generic available)

Microemulsion soft gelatin capsules (Gengraf, Neoral): 25 mg, 50 mg, 100 mg
Microemulsion oral solution (Gengraf, Neoral): 100 mg/mL
Soft gelatin capsules (Sandimmune): 25 mg, 100 mg
Oral solution (Sandimmune): 100 mg/mL
Injection (Sandimmune): 50 mg/mL

Nursing implications

Nursing assessment

  • Monitor serum creatinine level, intake and output ratios, daily weight, and BP during therapy. Report significant changes.
  • Assess for any new signs or symptoms that may be suggestive of progressive multifocal leukoencephalopathy (PML), an opportunistic infection of the brain caused by the Jakob Cruzfeldt (JC) virus, that may be fatal; withhold dose and notify health care professional promptly. PML symptoms may begin gradually (hemiparesis, apathy, confusion, cognitive deficiencies, and ataxia) and may include deteriorating renal function and renal graft loss.
  • Monitor for signs and symptoms of posterior reversible encephalopathy syndrome (PRES) (impaired consciousness, convulsions, visual disturbances including blindness, loss of motor function, movement disorders and psychiatric disturbances, papilloedema, visual impairment). Usually reversible with discontinuation of cyclosporine. Occurs more often in patients with liver transplant than kidney transplant.
  • Prevention of Transplant Rejection: Assess for symptoms of organ rejection throughout therapy.
  • Intravenous: Monitor patient for signs and symptoms of hypersensitivity (wheezing, dyspnea, flushing of face or neck) continuously during at least the first 30 min of each treatment and frequently thereafter. Oxygen, epinephrine, and equipment for treatment of anaphylaxis should be available with each IV dose.
  • Arthritis: Assess pain and limitation of movement prior to and during administration.
    • Prior to initiating therapy, perform a physical exam including BP on 2 occasions to determine baseline. Monitor BP every 2 wk during initial 3 mo, then monthly if stable. If hypertension occurs, dose should be reduced.
  • Psoriasis: Assess skin lesions prior to and during therapy.
  • Lab Test Considerations: Measure serum creatinine, BUN, CBC, magnesium, potassium, uric acid, and lipids at baseline, every 2 wk during initial therapy, and then monthly if stable. Nephrotoxicity may occur; report significant increases.
    • May cause hepatotoxicity; monitor for ↑ AST, ALT, alkaline phosphatase, amylase, and bilirubin.
    • May cause ↑ serum potassium and uric acid levels and ↓ serum magnesium levels.
    • Serum lipid levels may be ↑.
  • Evaluate serum cyclosporine levels periodically during therapy. Dose may be adjusted daily, in response to levels, during initiation of therapy. Guidelines for desired serum levels will vary among institutions.

Potential Nursing Diagnoses

Chronic pain (Indications)
Risk for infection (Side Effects)


  • Do not confuse cycloSPORINE with cyclophosphamide or cycloSERINE. Do not confuse Sandimmune with Sandostatin.
    • Given with other immunosuppressive agents. Protect transplant patients from staff and visitors who may carry infection. Maintain protective isolation as indicated.
    • Microemulsion products (Neoral) and other products (Sandimmune) are not interchangeable.
  • Oral: Draw up oral solution in the pipette provided with the medication. Mix oral solution with milk, chocolate milk, apple juice, or orange juice, preferably at room temperature. Stir well and drink at once. Use a glass container and rinse with more diluent to ensure that total dose is taken. Administer oral doses with meals. Wipe pipette dry; do not wash after use.
  • Intravenous Administration
  • pH: No Data.
  • Intermittent Infusion: Diluent: Dilute each 1 mL (50 mg) of IV concentrate immediately before use with 20–100 mL of D5W or 0.9% NaCl for injection. Solution is stable for 24 hr in D5W. In 0.9% NaCl, it is stable for 6 hr in a polyvinylchloride container and 12 hr in a glass container at room temperature.Concentration: 2.5 mg/mL.
  • Rate: Infuse slowly over 2–6 hr via infusion pump.
  • Continuous Infusion: May be administered over 24 hr.
  • Y-Site Compatibility: alemtuzumab, alfentanil, amikacin, aminocaproic acid, aminophylline, amphotericin B lipid complex, anidulafungin, argatroban, ascorbic acid, atracurium, atropine, azathioprine, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorpohanol, calcium chloride, calcium gluconate, carboplatin, carmustine, caspofungin, cefazolin, cefoperazone, cefotaxime, cefotetan, cefoxitin, ceftaroline, ceftazidime, ceftriaxone, cefuroxime, chloramphenicol, chlorpromazine, cisplatin, clindamycin, cyclophosphamide, cytarabine, dactinomycin, daptomycin, dexamethasone, dexmedetomidine, dexrazoxane, digoxin, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doripenem, doxacurium, doxarubicin hydrochloride, doxorubicin liposomal, doxycycline, enalaprilat, ephedrine, epinephrine, epirubicin, epoetin alfa, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, fluorouracil, folic acid, foscarnet, furosemide, ganciclovir, gemcitabine, gentamicin, glycopyrrolate, granisetron, heparin, hetastarch, hydrocortisone, hydromorphone, ifosfamide, imipenem/cilastatin, indomethacin, irinotecan, isoproterenol, ketorolac, labetalol, leucovorin calcium, levofloxacin, lidocaine, linezolid, lorazepam, mannitol, mechlorethamine, meperidine, meropenem, metaraminol, methotrexate, methyldopate, methylprednisolone, metoclopramide, metoprolol, metronidazole, micafungin, midazolam, milrinone, mitoxantrone, morphine, moxifloxacin, multivitamins, nafcillin, naloxone, nesiritide, nicardipine, nitroglycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, paclitaxel, palonosetron, pamidronate, pancuronium, papaverine, pemetrexed, penicillin G,, pentamidine, pentazocine, phentolamine, phenylephrine, phytonadione, piperacillin/tazobactam, potassium acetate, potassium chloride, prochlorperazine, promethazine, propofol, propranolol, protamine, pyridoxime, quinupristin/dalfopristin, ranitidine, sargramostim, sodium acetate, sodium bicarbonate, streptokinase, succinylcholine, sufentanil, tacrolimus, teniposide, theophylline, thiamine, thiotepa, ticarcillin/clavulanate, tigecycline, tirofiban, tobramycin, tolazoline, vancomycin, vasopressin, vecuronium, verapamil, vinblastine, vincristine, vinorelbine, zoledronic acid
  • Y-Site Incompatibility: amphotericin B cholesteryl, amphotericin B liposome, cyanocobalamin, dantrolene, diazepam, diazoxide, idarubicin, pentobarbital, phenobarbital, phenytoin, rituximab, trastuzumab, trimethoprim/sulfamethoxazole, voriconazole

Patient/Family Teaching

  • Instruct patient to take medication at the same time each day with meals, as directed. Do not skip doses or double up on missed doses. Take missed doses as soon as remembered within 12 hr. Do not discontinue medication without advice of health care professional.
  • Reinforce the need for lifelong therapy to prevent transplant rejection. Review symptoms of rejection for transplanted organ, and stress need to notify health care professional immediately if they occur.
  • Instruct patients and/or parents to notify health care professional if diarrhea develops; decreases absorption of cyclosporine and can result in rejection.
  • Instruct patient to avoid grapefruit and grapefruit juice to prevent interaction with cyclosporine.
  • Advise patient of common side effects (nephrotoxicity, increased BP, hand tremors, increased facial and body hair, gingival hyperplasia). Advise patients that if hair growth is excessive, depilatories or waxing can be used.
  • Teach patient the correct method for monitoring BP. Instruct patient to notify health care professional of significant changes in BP or if hematuria, increased frequency, cloudy urine, decreased urine output, fever, sore throat, tiredness, or unusual bruising occurs.
  • Instruct patient on proper oral hygiene. Meticulous oral hygiene and dental examinations for teeth cleaning and plaque control every 3 mo will help decrease gingival inflammation and hyperplasia.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking other Rx, OTC, or herbal products or receiving any vaccinations while taking this medication.
  • Advise patient to notify health care professional if pregnancy is planned or suspected, or if breast feeding.
  • Emphasize the importance of follow-up exams and lab tests.

Evaluation/Desired Outcomes

  • Prevention of rejection of transplanted tissues.
  • Decrease in severity of pain.
    • Increased ease of joint movement.
  • Decrease in progression of psoriasis.
Drug Guide, © 2015 Farlex and Partners


A trademark for the drug cyclosporine.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.


Cyclosporin, see there.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
* Other non-neurotropic drugs: isotretinoin (Accutane--used to treat acne), cyclosporine (Grengraf, Neoral, Sandimmune, Sangcya--used to treat organ rejection, rheumatoid arthritis, psoriasis), mefloquine (Larium--used to prevent and treat malaria), trihexyphenidyl (Artane--used to treat tremors and symptoms of Parkinson's disease), hepatitis B vaccine, and the atypical antidepressant bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban, Budeprion--used to treat depression, seasonal affective disorder, and to promote smoking cessation).
The animals were injected subcutaneously with 15 mg/kg cyclosporine A (Sandimmune Neoral, Novartis Pharmaceuticals, UK) each day, starting with a 30 mg/kg injection one day before surgery.
The required label changes affect the following drugs used to help prevent rejection of transplanted organs:--Rapamune (sirolimus) Sandimmune (cyclosporine) and cyclosporine generics--Neoral (cyclosporine modified), and generics - Cellcept (mycophenolate mofetil) and generics--Myfortic (mycophenolic acid) The FDA is requiring the labeling changes based on its review of reported adverse events.
Other drugs known to leach DEHP from PVC tubing are: Etoposide (VePesid), Teniposide (Vumon), Librium, Monistat, Sandimmune, Tacrolimus, Fat Emulsions and Vitamin A.
TABLE 6 Agents with reported potential drug interactions (20-23, 25-26, 32, 33, 45) Drug Possible interactions Histamine 2 Fluoxetine (Prozac), chemotherapy drugs, cyclosporine receptor (Sandimmune, Neoral, Restasis), warfarin (Coumadin, antagonists Jantoven), carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), isoniazid (Nydrazid), ciprofloxacin (Cipro, Proquin XR), ketoconazole (Nizoral, Xolegel), valproic acid (Depakene, Depakote, Stavzor), theophylline (Theo-Dur, Theolair, Slo-phyllin), and midazolam Proton pump Warfarin (Coumadin Jantoven), atazanavir (Rayataz), inhibitors ketoconazole (Nizoral, Xolegel), iron salts, digoxin (Lanoxin, Digitek), cyclosporine (Sandimmune, Neoral, Restasis), and tacrolimus (Protopic, Prograf), clopidogrel (Plavix)
Other agents like methotrexate (Folex, Mexate, Rheumatrex), azathioprine (Asasan), mycophenolate mofetil (Cellcept), leflunamide (Arava) and cyclosporine (Sandimmune, Neoral) are sometimes used to control symptoms of lupus.
Medications that may cause gout include some diuretics ("water pills"), niacin, aspirin, cyclosporine (Sandimmune), and some drugs used to treat cancer.
Synthetic DMARDs include azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), gold compounds, hydroxychloroquine (Plaquenil), leflunomide (Arava), methotrexate, penicillamine, and sulfasalazine (Azulfidine).
The following drugs have been found to interact with grapefruit juice (to be sure of your medications, ask your pharmacist): calcium channel blockers (for high blood pressure)--felodipine (Plendil), nifedipine (Procardia, Adalat), nisoldipine (Sular); immunosuppressant drugs (for organ transplants)--cyclosporine (Neoral, Sandimmune, SangCya), tacrolimus (Prograf); drugs for anxiety, insomnia or depression--diazepam (Valium), triazolam (Halcion), zaleplon (Sonata), carbamazepine (Tegretol), clomipramine (Anafranil).
Comparative bioavailability of Neoral and Sandimmune in cardiac transplant recipients over one year.
The product when administered systemically (Sandimmune, Neoral), is an effective treatment for psoriasis, atopic dermatitis, pemphigus vulgaris and other severe inflammatory dermatoses.