N.A.S.S Dingwall Branch Information Page

Link to full Index

Cyclosporine (Sandimmune)

(BRITISH) UK Trade name products: (Sandimmun)

INDICATION

This is an immunosuppresive agent used to prevent organ rejection in kidney, liver, bone marrow, or heart transplant patients.

SIDE EFFECTS

Common side effects are: inflammation of the gums, blood in the urine, jaundice, tremors, and increased hair growth. Other less common effects include: headache, hypertension, hyperplasia (enlargement) of the gums, nausea, vomiting, diarrhoea, oral thrush, fever, sore throat, leg cramps, kidney toxicity, liver toxicity, acne, sinusitis, and flushing. Rare side effects include: confusion, irregular heart beat, abdominal pain, and weakness.

INTERACTIONS and PRECAUTIONS

  1. Aminoglycosides (e.g. gentamicin, tobramycin) and nonsteroidal anti-inflammatories (ibuprofen and others) can increase the risk of kidney toxicity. 2. Corticosteroids, cyclophosphamide, and verapamil can increase immunosuppression.
  2. Carbamazepine, isoniazid, phenobarbitone, phenytoin, and rifampicin can lead to a possible immunosuppressant effect.
  3. Ketoconazole, cimetidine, diltiazem, and erthyromycin may all increase blood levels of cyclosporin (risk of toxicity).
  4. Monitor kidney profile closely.
  5. Monitor liver profile closely.
  6. Cyclosporin blood levels can be monitored.
  7. Use with spironolactone, (Dyazide), (Maxide) can lead to increased cyclosporin effect.
  8. Use with oestrogens (e.g. Premarin) can increase the effect of cyclosporin.
  9. Use with fluconazole can increase the effect of cyclosporin.
  10. Use with lovastatin can increase risk of damage to heart and kidneys.
  11. Use with virus vaccines can increase adverse reactions to vaccine.

USUAL DOSE

Adults:

For transplant rejection prevention: oral, 12-15 mg/kg body weight per day (initially), beginning four to twelve hours before surgery and continuing for 2 weeks after surgery. Maintenance dosing of 5-10 mg/kg body weight per day.

Paediatrics: see adult dosing.

Link to full Index