Cyclosporine

Therapeutic Category Immunosuppressant Pharmacologic class: Immunosuppressant agent Use\ Indications Immunosuppressant which may be used with azathioprine and/or corticosteroids to prolong organ and patient survival in kidney, liver, and heart transplants; used in allogeneic bone marrow transplants for prevention and treatment of graft-versus-host disease; also used in some cases of severe autoimmune disease that are resistant to corticosteroids and other therapy. Pharmacological Effects Inhibition of production and release of interleukin II and inhibits interleukin II-induced activation of resting T-lymphocytes Adverse Reaction Cardiovascular: Hypertension Dermatologic: Hirsutism, Acne Endocrine & metabolic: Hypomagnesemia, hyperkalemia Gastrointestinal: Gingival hyperplasia, Abdominal discomfort, nausea, vomiting Neuromuscular & skeletal: Tremor, Leg cramps Renal: Nephrotoxicity Central nervous system: Seizure, headache Hepatic: Hepatotoxicity Miscellaneous: Increased susceptibility to infection

Precautions/Warnings/Contraindication Infection and possible development of lymphoma may result. Make dose adjustments to avoid toxicity or possible organ rejection using cyclosporine blood levels because absorption is erratic and elimination is highly variable. Administer with adrenal corticosteroids but not with other immunosuppressive agents. Nephrotoxic: If possible avoid concomitant use of other potentially nephrotoxic drugs (eg, acyclovir, aminoglycoside antibiotics, amphotericin B, ciprofloxacin). Injectable form contains ethanol. Pregnancy category: C Interactions: Increased toxicity: Drugs that increase cyclosporine concentrations: Azithromycin, clarithromycin, diltiazem, erythromycin, fluconazole, itraconazole, ketoconazole, nicardipine, verapamil, grapefruit juice Drugs that enhance nephrotoxicity of cyclosporine: Aminoglycosides, amphotericin B, acyclovir Lovastatin - myositis, myalgias, rhabdomyolysis, acute renal failure Nifedipine - increases risk of gingival hyperplasia

Cyclosporine cont. Dosing Children and Adults (oral dosage is ~3 times the I.V. dosage); dosage should be based on ideal body weight: Initial: 5-6 mg/kg/day beginning 4-12 hours prior to organ transplantation. Patients should be switched to oral cyclosporine as soon as possible Brand Available: Parentrals Sandimmum 50mg/ml Tablets:
Cipol-N 50mg

Sandimmum 25mg Sandimmum 100mg Ciprokia 250mg