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Drug Info > N > Neoral
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Brand Name

Neoral

Common Name
cyclosporine (by mouth)


In this drug factsheet:



How does this medication work? What will it do for me?

Cyclosporine belongs to the groups of medications known as immunosuppressant agents. It is used to prevent the rejection of organ transplants and bone marrow transplants by suppressing the body's natural defence, the immune system. It is also used to treat rheumatoid arthritis, which is thought to be caused by the body's own immune system attacking the joints of the body.

Cyclosporine is also used to treat severe psoriasis when other treatments have not been effective. It has also been found helpful in the treatment of a kidney condition known as nephrotic syndrome.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended dose of cyclosporine varies according to weight and circumstances.

For solid organ transplants, the recommended dose is 10 mg to 15 mg per kilogram of body weight daily (in 2 divided doses) starting at least 12 hours before surgery. The dose usually stays the same for 1 or 2 weeks after the operation and then is reduced gradually by the doctor so that a particular level of the medication in the bloodstream is reached.

For bone marrow transplants, the oral form of the medication is usually given at a daily dose of about 12.5 mg per kilogram of body weight in 2 divided doses. This dose is usually continued for 3 to 6 months and then decreased gradually until it is stopped, about one year after the operation.

For treatment of psoriasis, the recommended oral starting dose is 2 mg per kilogram of body weight per day in 2 divided doses. If no improvement is seen in one month, the doctor may increase the daily dose gradually. The daily dose of cyclosporine should not go above 5 mg per kilogram of body weight per day. If there is still no improvement after 6 weeks of treatment, the treatment should be stopped. If the psoriasis improves, the doctor may gradually decrease the dose. Psoriasis often returns once the medication is stopped, so the goal of treatment is usually to find the smallest dose that will be effective.

For treatment of rheumatoid arthritis, the recommended dose is 2 mg per kilogram of body weight per day in 2 divided doses for the first 6 weeks of treatment. If the desired improvement is not seen, the doctor may increase the dose gradually as long as the medication is still well tolerated.

For nephrotic syndrome, the recommended starting dose is 3.5 mg per kilogram of body weight per day for adults and 4.2 mg per kilogram of body weight per day for children. People with reduced kidney function should not receive more than 2.5 mg per kg body weight per day. The dose is usually increased to a maximum of 5 mg per kilogram in adults, or 6 mg per kilogram in children. Treatment should be stopped if no improvement is seen within 3 months of starting treatment.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store cyclosporine capsules and solution at room temperature and protect from direct light. Once the solution has been opened, it must be used within 2 months. It should not be stored below 20°C for a long period of time because a jelly-like formation may occur. If minor flakes or slight sediments are seen, the effectiveness and safety of the product and dosing will remain accurate.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.





What form(s) does this medication come in?

Capsules

10 mg
Each soft gelatin capsule contains cyclosporine for microemulsion 10 mg. Nonmedicinal ingredients: dl-a-tocopherol, ethanol, hydrogenated castor oil, maize oil, and propylene glycol; shell: gelatin, glycerol, and propylene glycol; colouring agents: aluminum chloride, hydroxypropyl methylcellulose, sodium hydroxide, and titanium dioxide.

25 mg
Each soft gelatin capsule contains cyclosporine for microemulsion 25 mg. Nonmedicinal ingredients: dl-a-tocopherol, ethanol, hydrogenated castor oil, maize oil, and propylene glycol; shell: gelatin, glycerol, and propylene glycol; colouring agents: aluminum chloride, carminic acid, hydroxypropyl methylcellulose, iron oxide black, sodium hydroxide, and titanium dioxide.

50 mg
Each soft gelatin capsule contains cyclosporine for microemulsion 50 mg. Nonmedicinal ingredients: dl-a-tocopherol, ethanol, hydrogenated castor oil, maize oil, and propylene glycol; shell: gelatin, glycerol, and propylene glycol; colouring agents: aluminum chloride, hydroxypropyl methylcellulose, sodium hydroxide, and titanium dioxide.

100 mg
Each soft gelatin capsule contains cyclosporine for microemulsion 100 mg. Nonmedicinal ingredients: dl-a-tocopherol, ethanol, hydrogenated castor oil, maize oil, and propylene glycol; shell: gelatin, glycerol, and propylene glycol; colouring agents: aluminum chloride, carminic acid, hydroxypropyl methylcellulose, iron oxide black, sodium hydroxide, and titanium dioxide.

Solution

Each mL contains cyclosporine for microemulsion 100 mg dissolved. Nonmedicinal ingredients: dl-a-tocopherol, ethanol, hydrogenated castor oil, maize oil, and propylene glycol.

Who should NOT take this medication?

Cyclosporine should not be taken by anyone who:

  • is allergic to cyclosporine or to any of the ingredients of the medication
  • is being treated for psoriasis or rheumatoid arthritis who also has:
    • abnormal kidney function
    • any type of condition that negatively affects the function of the immune system
    • cancer (except nonmelanoma skin cancer)
    • uncontrolled high blood pressure
    • uncontrolled infection


 

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