$Unique_ID{BRK03114} $Pretitle{} $Title{cyclosporine} $Subject{Sandimmune Sandoz Immunosuppressant cyclosporine organ rejection kidney liver heart transplants rejection foreign tissue} $Volume{} $Log{} Copyright (C) 1993 Publications International, Ltd. cyclosporine ------------------------------------------------------------------------------ BRAND NAME (Manufacturer) Sandimmune (Sandoz) TYPE OF DRUG Immunosuppressant INGREDIENT cyclosporine DOSAGE FORMS Oral solution (100 mg per ml, with 12.5% alcohol) Soft gelatin capsules (25 mg and 100 mg) STORAGE Cyclosporine oral solution and capsules should be stored in the original container at room temperature. This medication should never be refrigerated or frozen. Once the solution has been opened, it should be used within two months. USES Cyclosporine is used to prevent organ rejection after kidney, liver, and heart transplants. It is not clearly understood how cyclosporine works, but it appears to prevent the body's rejection of foreign tissue. TREATMENT To make it more palatable, the solution should be diluted with milk, chocolate milk, or orange juice (preferably at room temperature). The dose should be measured carefully with the dropper provided and placed in one of the fluids listed above. Use a glass container (cyclosporine chemically binds to wax-lined and plastic surfaces). Stir well and drink at once--do not allow the mixture to stand before drinking. Refill the glass with the same beverage and drink this solution to ensure that the whole dose is taken. The dropper should be wiped with a clean towel after use and stored in its container. If the dropper has been cleaned, make sure it is completely dry before using it again. It is important not to miss any doses of this medication. If you do miss a dose, take the missed dose as soon as possible, unless it is almost time for the next dose. In that case, do not take the missed dose at all; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Abdominal discomfort, diarrhea, flushing, headache, hiccups, leg cramps, loss of appetite, nausea, or vomiting. These side effects should disappear as your body adjusts to the medication. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about acne; bleeding, tender, or enlarged gums; convulsions; difficult or painful urination; enlarged and painful breasts (in both sexes); fever; hair growth; hearing loss; muscle pain; rapid weight gain (three to five pounds within a week); sore throat; tingling of the hands or feet; tremors; unusual bleeding or bruising; or yellowing of the eyes or skin. INTERACTIONS Cyclosporine interacts with several other types of drugs: 1. Carbamazepine, isoniazid, rifampin, phenytoin, phenobarbital, and trimethoprim/sulfamethoxazole can decrease the blood levels of cyclosporine, decreasing its effectiveness. 2. Cimetidine, diltiazem, erythromycin, ketoconazole, oral contraceptives, danazol, and amphotericin B can increase the blood levels of cyclosporine, which can lead to an increase in side effects. 3. Tell your doctor if you are currently taking corticosteroids, verapamil, or nonsteroidal anti-inflammatory drugs. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to cyclosporine or to polyoxyethylated castor oil. * Before starting to take this medication, be sure to tell your doctor if you now have or if you have ever had hypertension (high blood pressure) or gastrointestinal disorders. * Repeated laboratory tests are necessary while you are taking cyclosporine to ensure that you are receiving the correct dosage and to avoid liver and kidney damage. * Certain cancers have occurred in patients receiving cyclosporine and other immunosuppressant drugs after transplantation. No causal effect has been established, however. * Do not stop taking this medication without first consulting your doctor. If the drug is stopped abruptly, organ rejection may occur. Your doctor may, therefore, want to reduce your dosage gradually or start you on another drug if treatment with this drug is to be discontinued. * Be sure to tell your doctor if you are pregnant. Although extensive studies in humans have not been conducted, cyclosporine has caused fetal damage when administered to animals. Also, tell your doctor if you are breast-feeding, because cyclosporine passes into breast milk. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.