Neoral

Neoral

     * Generic Name: cyclosporine
     * Brand Name: Neoral


     * What is cyclosporine (Gengraf, Neoral, SandIMMUNE)?
     * What are the possible side effects of cyclosporine (Gengraf,
       Neoral, SandIMMUNE)?
     * What is the most important information I should know about
       cyclosporine (Gengraf, Neoral, SandIMMUNE)?
     * What should I discuss with my health care provider before
       taking cyclosporine (Gengraf, Neoral, SandIMMUNE)?
     * How should I take cyclosporine (Gengraf, Neoral, SandIMMUNE)?
     * What happens if I miss a dose (Gengraf, Neoral, SandIMMUNE)?
     * What happens if I overdose (Gengraf, Neoral, SandIMMUNE)?
     * What should I avoid while taking cyclosporine (Gengraf, Neoral,
       SandIMMUNE)?
     * What other drugs will affect cyclosporine (Gengraf, Neoral,
       SandIMMUNE)?
     * Where can I get more information (Gengraf, Neoral, SandIMMUNE)?

What is cyclosporine (Gengraf, Neoral, SandIMMUNE)?

   Cyclosporine lowers your body's immune system. The immune
   system helps your body fight infections. The immune system can also
   fight or "reject" a transplanted organ such as a liver or kidney. This
   is because the immune system treats the new organ as an invader.

   Cyclosporine is used to prevent organ rejection after a kidney, heart,
   or liver transplant. Cyclosporine is also used to treat severe
   psoriasis or severe rheumatoid arthritis.

   Cyclosporine may also be used for purposes not listed in this
   medication guide.

What are the possible side effects of cyclosporine (Gengraf, Neoral,
SandIMMUNE)?

   Get emergency medical help if you have signs of an allergic reaction:
   hives; difficult breathing; swelling of your face, lips, tongue, or
   throat.

   Call your doctor at once if you have:
     * change in your mental state, problems with speech or walking,
       decreased vision (may start gradually and get worse quickly);
     * easy bruising, unusual bleeding (nose, mouth, vagina, or
       rectum), purple or red pinpoint spots under your skin;
     * pale or yellowed skin, dark colored urine, fever, confusion or
       weakness;
     * dangerously high blood pressure--severe headache, blurred vision,
       pounding in your neck or ears, nosebleed, anxiety, confusion,
       severe chest pain, shortness of breath, irregular heartbeats;
     * high potassium--nausea, slow or unusual heart rate, weakness, loss
       of movement;
     * kidney problems--little or no urinating, painful or difficult
       urination, swelling in your feet or ankles, feeling tired or short
       of breath;
     * liver problems--nausea, upper stomach pain, itching, tired feeling,
       loss of appetite, dark urine, clay-colored stools,
       jaundice (yellowing of the skin or eyes); or
     * signs of infection--fever, chills, flu-like symptoms, mouth
       sores, skin sores, feeling light-headed or short of breath, rapid
       heart rate.

   Common side effects may include:
     * tremors or shaking;
     * acne, increased growth of facial or body hair;
     * increased blood pressure;
     * nausea, diarrhea; or
     * swollen or painful gums.

   This is not a complete list of side effects and others may occur. Call
   your doctor for medical advice about side effects. You may report side
   effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about cyclosporine
(Gengraf, Neoral, SandIMMUNE)?

   Cyclosporine may increase your risk of developing serious infections,
   cancer, or transplant failure. Talk with your doctor about the risks
   and benefits of using this medication.

   You may not be able to use this medicine if you have kidney disease,
   untreated or uncontrolled hypertension (high blood pressure),
   any type of cancer, or psoriasis that has been treated with PUVA,
   UVB, radiation, methotrexate (Trexall), or coal tar. MAKE
   SURE ALL DOCTORS INVOLVED IN YOUR CARE KNOW YOU ARE TAKING
   CYCLOSPORINE.

   Cyclosporine can cause serious side effects, including kidney failure
   or life-threatening infection. While using cyclosporine, you will need
   frequent blood tests to be sure cyclosporine is not causing harmful
   effects.

   Neoral Patient Information including How Should I Take
   Digestive Disease Myths:Common Misconceptions

   Digestive Disease Myths Slideshow Pictures
   RxList

   10 Facts About the Amazing Brain
   Weight Gain Shockers:Surprising Reasons You're Gaining Weight

   Weight Gain Shockers Slideshow

What should I discuss with my health care provider before taking cyclosporine
(Gengraf, Neoral, SandIMMUNE)?

   You should not use cyclosporine if you are allergic to it. You may not
   be able to use cyclosporine if you have:
     * kidney disease;
     * untreated or uncontrolled high blood pressure; or
     * any type of cancer.

   If you are being treated for psoriasis, you should not receive
   ultraviolet light therapy (PUVA or UVB), radiation treatments, coal
   tar, or drugs that weaken the immune system (such as methotrexate)
   while you are receiving cyclosporine.

   Cyclosporine can lower blood cells that help your body fight
   infections, or cause your body to produce too much of a certain type of
   white blood cells. This can lead to serious and sometimes fatal
   conditions, including cancer, a severe brain infection that can lead to
   disability or death, or a virus that can cause failure of a
   transplanted kidney. Talk with your doctor about your specific risk.

   MAKE SURE ALL DOCTORS INVOLVED IN YOUR CARE KNOW YOU ARE TAKING
   CYCLOSPORINE.

   It is not known whether this medicine will harm an unborn baby. Tell
   your doctor if you are pregnant or plan to become pregnant.

   Cyclosporine can pass into breast milk and may harm a nursing baby. You
   should not breast-feed while you are using cyclosporine.

How should I take cyclosporine (Gengraf, Neoral, SandIMMUNE)?

   Follow all directions on your prescription label. Your doctor may
   occasionally change your dose to make sure you get the best results. Do
   not take this medicine in larger or smaller amounts or for longer than
   recommended.

   You may take cyclosporine with or without food, but take it the same
   way each time. Cyclosporine should be given in two separate doses each
   day. Try to take the medication at the same dosing times each day.

   If your doctor changes your brand, strength, or type of cyclosporine,
   your dosage needs may change. Ask your pharmacist if you have any
   questions about the new kind of cyclosporine you receive at the
   pharmacy.

   Measure liquid medicine with the dosing syringe provided, or with a
   special dose-measuring spoon or medicine cup. If you do not have a
   dose-measuring device, ask your pharmacist for one. Sandimmune oral
   solution may be mixed with milk, chocolate milk, or orange juice at
   room temperature to make the medicine taste better. Neoral "modified"
   (microemulsion) oral solution should be mixed with orange juice or
   apple juice that is at room temperature.

   While using cyclosporine, you will need frequent blood or urine tests
   to be sure cyclosporine is not causing harmful effects.

   Your condition may need to be treated with a combination of different
   drugs. Use all medications as directed by your doctor. Read the
   medication guide or patient instructions provided with each medication.
   Do not change your doses or medication schedule without your doctor's
   advice. Every person taking cyclosporine should remain under the care
   of a doctor.

   Store at room temperature away from moisture and heat.

   Neoral Patient Information including If I Miss a Dose
   Digestive Disease Myths:Common Misconceptions

   Digestive Disease Myths Slideshow Pictures
   RxList

   10 Facts About the Amazing Brain
   Weight Gain Shockers:Surprising Reasons You're Gaining Weight

   Weight Gain Shockers Slideshow

What happens if I miss a dose (Gengraf, Neoral, SandIMMUNE)?

   Take the missed dose as soon as you remember. Skip the missed dose if
   it is almost time for your next scheduled dose. Do not take extra
   medicine to make up the missed dose.

What happens if I overdose (Gengraf, Neoral, SandIMMUNE)?

   Seek emergency medical attention or call the Poison Help line at
   1-800-222-1222.

What should I avoid while taking cyclosporine (Gengraf, Neoral, SandIMMUNE)?

   Grapefruit and grapefruit juice may interact with cyclosporine and
   lead to unwanted side effects. Avoid the use of grapefruit products
   while taking cyclosporine.

   Avoid being near people who are sick or have infections. Tell your
   doctor at once if you develop signs of infection.

   Do not receive a "live" vaccine while using cyclosporine. The vaccine
   may not work as well during this time, and may not fully protect you
   from disease. Live vaccines include measles, mumps,
   rubella (MMR), polio, rotavirus, typhoid,
   yellow fever, varicella (chickenpox), zoster
   (shingles), and nasal flu (influenza) vaccine.

   Avoid exposure to sunlight or tanning beds. Cyclosporine can make you
   sunburn more easily. Wear protective clothing and use sunscreen
   (SPF 30 or higher) when you are outdoors.

What other drugs will affect cyclosporine (Gengraf, Neoral, SandIMMUNE)?

   Cyclosporine can harm your kidneys. This effect is increased when you
   also use certain other medicines, including: antivirals,
   cholesterol-lowering drugs, chemotherapy, injected antibiotics,
   medicine for bowel disorders, medicines to treat autoimmune
   disorders, medicine to prevent organ transplant rejection, stomach acid
   reducers (Tagamet, Zantac), and some pain or arthritis
   medicines (including aspirin, Tylenol, Advil, and Aleve).

   Many drugs can interact with cyclosporine. Not all possible
   interactions are listed here. Tell your doctor about all your current
   medicines and any you start or stop using, especially:
     * ambrisentan or bosentan;
     * dabigatran;
     * rifabutin;
     * St. John's wort;
     * antibiotic or antifungal medicine;
     * antiviral medicine to treat hepatitis C or
       HIV/AIDS;
     * birth control pills;
     * cholesterol-lowering medication:
     * heart or blood pressure medication, including a diuretic or
       "water pill";
     * seizure medication; or
     * steroid medication (oral, nasal, inhaled, or injectable).

   This list is not complete and many other drugs can interact with
   cyclosporine. This includes prescription and over-the-counter
   medicines, vitamins, and herbal products. Give a list of all your
   medicines to any healthcare provider who treats you.

Where can I get more information (Gengraf, Neoral, SandIMMUNE)?

   Your pharmacist can provide more information about cyclosporine.
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