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Cyclosporine (Neoral,
Sandimmune)
Available: Capsules
� 25 mg, 50 mg, 100 mg
Microemulsion capsules � 25 mg, 100 mg
Emulsion or oral solution � 100 mg/mL
Injection � 50 mg/mL
Cost: 100 mg, #30 =
$131.99; #60 = $299.95
Dose: 2.5-5 mg/kg
(can be dosed for certain conditions)
Indications:
Treating rheumatoid arthritis, psoriatic arthritis, recurrent
uveitis, or moderate to severe complications of lupus
Side effects: High
blood pressure or a decrease in kidney function may require a
dose adjustment. This medication may increase uric acid
levels, either worsening pre-existing gout or less commonly
inducing gout. Other side effects include low blood counts,
headache, tremors, neuropathy (uncommon), increased hair
growth, muscle cramps, swelling of the gums, nausea, vomiting,
abdominal pain and swelling of the hands or feet.
Monitoring: Baseline
blood pressure, weight gain, blood count, kidney and liver
function, and uric acid levels are advisable. Blood pressure
and weight should be monitored every 2 weeks until the dose is
stable, then monthly. Kidney function should be monitored
monthly, with blood counts, liver function tests, and
electrolytes periodically while taking this medication. Drug
levels can also be monitored but this is generally not
necessary with doses under 5 mg/kg/day.
Important things to know:
Cyclosporine may result in a greater chance for
some cancers, particularly skin cancers. This risk is much
more significant at higher doses. Sun screens and yearly skin
exams are important. Notify your provider of any weight gain
of > 5 lbs. in 24 hours. To decrease chances of gum disease,
brush and floss regularly. Avoid grapefruit and grapefruit
juice, as this affects the blood levels of cyclosporine. Many
medications also interact with cyclosporine. Patients must be
certain they provide accurate medication lists to all
providers and tell any provider to check for interactions.
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