cyclosporine modified
Cyclosporine modified (Neoral) is an immunosuppressant that helps prevent organ rejection after a kidney, liver, or heart transplant. It also treats severe rheumatoid arthritis and plaque psoriasis in adults. This medication comes in soft gelatin capsules and an oral solution. It's taken by mouth twice daily at a dosage that depends on your condition. Side effects can include high blood pressure, a lot of hair growth all over, and kidney problems. But it also has serious risks like infection and cancer. It's typically taken together with other medications. And although cyclosporine modified (Neoral) is interchangeable with Gengraf, it's not interchangeable with Sandimmune.
What is Cyclosporine modified (Neoral)?
What is Cyclosporine modified (Neoral) used for?
Preventing organ rejection after a kidney, liver, or heart transplant
Treating severe rheumatoid arthritis (RA)
Treating severe plaque psoriasis
How Cyclosporine modified (Neoral) works
Cyclosporine modified (Neoral) is a type of immunosuppressant medication. It lowers (or suppresses) the activity of your immune system. More specifically, the medication is a calcineurin inhibitor. It works by stopping a protein in the body called calcineurin from telling your immune system to become active.
For preventing organ rejection after a transplant: Your body recognizes the new organ as a foreign object. Your immune system fights to reject the new organ after the transplant. Cyclosporine modified (Neoral) stops your immune system from attacking the new organ, which lowers the risk for organ rejection.
For treating rheumatoid arthritis and plaque psoriasis: These medical conditions are caused by an overactive immune system. The immune system mistakes healthy tissue in your body as a foreign object and attacks it, leading to inflammation. Cyclosporine modified (Neoral) works to treat rheumatoid arthritis and plaque psoriasis by stopping your immune system from attacking your own body.
Drug Facts
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What are the side effects of Cyclosporine modified (Neoral)?
Common Side Effects
Side effects for transplant were reported in people taking a similar medication called cyclosporine (Sandimmune)
- Shaking (up to 55%)
- High blood pressure (up to 53%)
- Excessive hair growth on face, back, and chest (up to 45%)
- Kidney problems (up to 38%)
- Urinary tract infection (21%)
- Viral infections (16%)
- Overgrowth of gums (up to 16%)
- Nausea or vomiting (up to 10%)
- Higher creatinine levels (possible kidney problem; up to 48%)
- Headache (25%)
- High blood pressure (25%)
- Nausea (18%)
- Stomach pain (15%)
- Excessive hair growth on face, back, and chest (15%)
- Diarrhea (13%)
- General pain (13%)
- Shaking (13%)
- Upper respiratory tract infection (13%)
- Muscle cramps (12%)
- Numbness, tingling, or burning in arms or legs (11%)
- High blood pressure (28%)
- Infection (25%)
- Higher creatinine levels (possible kidney problem; 20%)
- Headache (16%)
- High triglyceride levels (15%)
Other Side Effects
- Diarrhea
- Indigestion
- Swelling
- Dizziness
- Infections or flu-like symptoms
- Chest pain
- Mouth sores
- Cough
- Difficulty breathing
- Stuffy nose
- Flushed skin
- Rash
Serious Side Effects
- Serious infection: fever, difficulty breathing, muscle weakness, confusion, memory problems, loss of balance or coordination, not able to move
- Severely high blood pressure: headache, difficulty breathing, chest pain or pressure, blurred vision, fast heartbeat, nose bleed, confusion
- Kidney damage: urinating less, swelling in feet or legs, shortness of breath, tiredness, weakness, muscle cramps, nausea, vomiting, confusion
- Liver damage: yellowing of the skin or eyes (jaundice), stomach pain or swelling, loss of appetite, nausea, vomiting, dark urine, tiredness, weakness, confusion
- Brain damage: vision problems (e.g., blurred vision, double vision, loss of vision), loss of muscle control, movement problems, changes in thoughts or behavior, seizures, loss of consciousness
Source:Â DailyMed
More on Cyclosporine modified (Neoral) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Abdominal or stomach pain or tenderness
back pain
black, tarry stools
blurred vision
chills
clay colored stools
cloudy urine
dark urine
decrease in urine output or decrease in urine-concentrating ability
decreased appetite
dizziness
drowsiness
headache
headache, severe and throbbing
loss of appetite
muscle spasms (tetany) or twitching
nervousness
painful or difficult urination
pounding in the ears
shakiness in the legs, arms, hands, or feet
shortness of breath
skin rash
slow or fast heartbeat
sores, ulcers, or white spots on the lips or in the mouth
swelling of the feet or lower legs
swollen glands
trembling or shaking of the hands or feet
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Less common
Bleeding gums
blood in the urine
blood in the vomit
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
convulsions
difficulty swallowing
pale skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
severe or continuing stomach pain
tightness in the chest
troubled breathing with exertion
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Abdominal or stomach discomfort
bleeding, tender, or enlarged gums
blemishes on the skin
increased hair growth, especially on the face
pain or tenderness around the eyes and cheekbones
stuffy or runny nose
Less common
Brittle fingernails
burning feeling in the chest or stomach
burning, dry, or itching eyes
continuing ringing or buzzing or other unexplained noise in the ears
cramps
discharge or excessive tearing
feeling of warmth
hearing loss
redness of the face, neck, arms, and occasionally, upper chest
redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
swelling of the breasts or breast soreness in both females and males
Rare
Blurred or loss of vision
discouragement
disturbed color perception
double vision
fear
feeling sad or empty
halos around lights
irritability
joint pain
loss of interest or pleasure
night blindness
overbright appearance of lights
tiredness
trouble concentrating
trouble sleeping
tunnel vision
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
weakness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cyclosporine modified (Neoral)
Pros
Comes as an easy-to-swallow soft gelatin capsule and liquid solution
Better and more stable absorption in your body than cyclosporine (Sandimmune)
Can help treat severe rheumatoid arthritis and plaque psoriasis when other medications haven't worked well
Cons
Might need regular blood draws to check medication levels in your body
Has a risk of serious infections and certain types of cancer
Can't easily switch back and forth with cyclosporine (Sandimmune)
Pharmacist tips for Cyclosporine modified (Neoral)
Take cyclosporine modified (Neoral) twice during the day at the same times each day. Also be consistent with taking the medication with food or without food. This helps make sure the cyclosporine levels in your body stay as stable as possible.
Your cyclosporine modified (Neoral) dose depends on the level of medication in your blood. You'll need regular blood draws done to check your cyclosporine levels. This helps your prescriber see whether your levels are within a safe range and whether you need any dose adjustments to get you to that range. Ask your prescriber how often you need to do lab work.
Don't make any changes to your dose or switch to cyclosporine (Sandimmune) without talking to your prescriber first. Cyclosporine modified (Neoral) and cyclosporine (Sandimmune) aren't equal to each other so it's not easy to switch between them. Your prescriber has to check your cyclosporine levels with any changes to treatment to make sure it's done safely. Treatment changes without guidance can lead to serious risks (e.g., transplant organ rejection, kidney damage).
Don't eat grapefruit or drink grapefruit juice while you're taking cyclosporine modified (Neoral). Grapefruit can make the cyclosporine levels in your body go up. This can lead to harmful effects, such as damage to the kidneys or liver.
Cyclosporine modified (Neoral) can cause kidney damage. Get medical care right away if you notice that you aren't urinating as much or if you have symptoms such as swelling in your feet or legs, trouble breathing, tiredness, or confusion.
Remember to use sunscreen, wear protective clothing, and try to stay in the shade if possible when you're outside. Cyclosporine modified (Neoral) can raise your risk for certain cancers, like skin cancer. Speak with your care team if you notice any unusual changes to your skin while you're taking this medication so you can get your skin checked out.
Ask your pharmacist or prescriber about which vaccines you can get while you're taking cyclosporine modified (Neoral). Before you get any vaccines, let the healthcare professional know that you're taking this medication. Some vaccines might not work as well. And avoid live vaccines, like Varivax (chickenpox vaccine) or the nasal spray flu vaccine. Your risk of getting sick from the live vaccine itself is higher because this medication lowers your ability to build immunity.
Store cyclosporine modified (Neoral) capsules at room temperature in the original pill bottle.
Other tips for the cyclosporine modified (Neoral) solution:
Only use the dosing syringe included in the original packaging to measure out the dose for the solution. Avoid using kitchen spoons because they won't give you an accurate dose. Ask your pharmacist if you're not sure whether you're measuring the dose correctly with the right kind of dosing syringe.
From the dosing syringe, place the measured amount of medication into a glass cup (not plastic) with some room-temperature orange or apple juice. Mix and then drink it right away. Add some more juice, mix, and drink what's left to make sure you get a full dose of your medication. Mixing the medication with juice helps it taste better and make it easier to swallow. Don't mix it with milk or grapefruit juice.
After you take cyclosporine modified (Neoral), use a clean towel to dry the outside of the dosing syringe and then put the protective cover back onto the bottle. Don't wash the syringe with water or any other cleaning agents. Be sure the dosing syringe is completely dry before you use it again.
Once you've opened the bottle of cyclosporine modified (Neoral) solution, use the medication in the bottle within 2 months.
Place the cyclosporine modified (Neoral) solution somewhere safe at room temperature (between 68ºF and 77ºF). The solution can turn into a gel with small chunks in it if it gets below 68°F. This won't damage the medication; let it reach the appropriate temperature range and the gel should turn back into a liquid.
Frequently asked questions about Cyclosporine modified (Neoral)
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What are the risks and warnings for Cyclosporine modified (Neoral)?
Cyclosporine modified (Neoral) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Prescribing physician must be experienced and treatment must be monitored
Cyclosporine modified (Neoral) should only be prescribed by a trained healthcare professional (HCP) who has experience with managing your condition (e.g., organ transplant, autoimmune condition). For your safety, your HCP will take detailed notes and closely monitor you at a hospital or clinic with all of the necessary medical resources to manage your treatment with cyclosporine modified (Neoral).
Not equal to cyclosporine (Sandimmune)
Risk factors: Switching between cyclosporine modified (Neoral) and cyclosporine (Sandimmune)
Cyclosporine modified (Neoral) is NOT equal to cyclosporine (Sandimmune), which is approved for preventing organ rejection after transplantation only. You can’t replace or interchange one with the other without first getting guidance from your prescriber. This is because you absorb more cyclosporine modified (Neoral) into the body than cyclosporine (Sandimmune). Switching between one form of cyclosporine to the other at the same dose changes the amount of medication in the body. This can lead to harmful consequences.
If your prescriber decides to switch between cyclosporine modified (Neoral) and cyclosporine (Sandimmune), they'll need to closely monitor the cyclosporine levels in your blood. This makes sure your cyclosporine levels are within a safe range. Levels that are too low can lead to organ rejection. And levels that are too high can lead to serious harm such as kidney or liver damage. Your transplant specialist will adjust your dose based on your cyclosporine levels.
Risk of serious infections
Risk factors: History of frequent infections | Had an organ transplant | Taking other medications that lower your immune system
Cyclosporine modified (Neoral) works by lowering or suppressing the activity of your immune system. It puts you at risk of infections that can become serious or even life-threatening. These can also include opportunistic infections (infections that usually only cause problems when the immune system is weak), like polyoma virus infections.
Your risk for serious bacterial, viral, or fungal infections is higher if you’re taking other medications that also weaken your immune system at the same time as cyclosporine modified (Neoral). This is especially common for people who've had an organ transplant. Let your prescriber know if you have a history of having frequent infections or if you're taking other immunosuppressants.
Contact an HCP if you have any signs of an infection, like fever, trouble breathing, cough, or chills. Also get medical help right away if you have muscle weakness, confusion, memory problems, loss of coordination, or paralysis. These can be signs of a serious infection that needs immediate medical attention.
Risk of cancer
Risk factors: History of cancer | Undergoing phototherapy | Taking methotrexate | Using coal tar | Radiation therapy | Exposure to a lot of sunlight or ultraviolet (UV) light | Taking cyclosporine modified (Neoral) long term | Taking other medications that can weaken the immune system
People who take cyclosporine modified (Neoral) are at higher risk for tumors and cancer, including lymphomas and skin cancer, among others. This is because the medication lowers (or suppresses) the activity of your immune system. Speak with your prescriber if you're worried about the risk for cancer during treatment.
Before you start cyclosporine modified (Neoral), let your care team know if you have a history of cancer. Also tell them if you're taking other immunosuppressants or getting treated with therapies that raise the risk for skin cancer (e.g., phototherapy, methotrexate). They can check your risk for cancer.
Lower your risk for skin cancer by avoiding excessive exposure to sunlight, using sunscreen, and wearing protective clothing when you’re outside. Contact your care team if you notice any unusual skin growths or changes to your skin while you're taking cyclosporine modified (Neoral). They can examine your skin to see what's going on.
High blood pressure
Risk factors: History of high blood pressure | Taking medications that raise blood pressure | High doses of cyclosporine modified (Neoral) | Taking cyclosporine modified (Neoral) for a long period of time
Your blood pressure can go up while you're taking cyclosporine modified (Neoral), even at recommended doses. High blood pressure is a common side effect, so your prescriber will check your blood pressure every so often. This side effect is typically mild or moderate.
The risk for high blood pressure might be greater with higher doses and long-term treatment. Your prescriber might lower your dose of cyclosporine modified (Neoral) if you have a history of high blood pressure or if you develop high blood pressure during treatment. Some people might also need to take certain blood pressure medications to manage this side effect.
Kidney damage
Risk factors: History of kidney problems | Older age | Taking medications that cause kidney damage | High dose of cyclosporine modified (Neoral) | Taking cyclosporine modified (Neoral) long term
Cyclosporine modified (Neoral) can cause kidney damage, even at usual doses. The risk is greater with higher doses and long-term treatment. You're also at higher risk if you have a history of kidney problems or if you're taking other medications that can harm the kidneys.
You'll need routine blood tests done so your prescriber can keep track of your kidney function while you’re taking cyclosporine modified (Neoral). Your prescriber might lower your dose to help manage this risk.
Let your care team know if you have symptoms like low urine production, swelling in your feet or legs, trouble breathing, tiredness, weakness, muscle cramps, nausea, vomiting, or confusion. For people who've have a kidney transplant, these signs and symptoms of kidney damage can be similar to those of organ rejection. It's possible to have kidney damage and organ rejection at the same time, which can be serious.
Liver damage
Risk factors: History of liver problems | Taking medications that cause liver damage | High dose of cyclosporine modified (Neoral) | Taking cyclosporine modified (Neoral) for a long period of time
Cyclosporine modified (Neoral) can cause liver damage, which can sometimes include liver failure and be life-threatening. The risk for liver damage while you're taking this medication is greater if your dose is high or if you're taking it for a long time. Some people who've had an organ transplant have had liver damage during the first month of treatment. Your prescriber will check your liver function while you're taking cyclosporine modified (Neoral).
Tell your care team right away if develop symptoms of liver damage. Watch out for yellowing of your skin or eyes (jaundice), stomach pain or swelling, loss of appetite, dark urine, nausea, vomiting, tiredness, weakness, or confusion. Your prescriber might lower your dose to help manage liver problems.
Brain damage
Risk factors: Taking high doses of steroids | High blood pressure | Low magnesium levels | Low cholesterol levels | High blood levels of cyclosporine | Organ transplant, especially liver transplant | Graft-versus-host disease
Some people who've taken a medication containing cyclosporine like cyclosporine modified (Neoral) have had brain damage. It can especially happen when people take this medication with high doses of steroids, such as methylprednisolone (Medrol). Your risk of brain damage might also be higher if you've had a liver transplant than if you've had a kidney transplant. The brain damage might improve with lower doses of cyclosporine modified (Neoral). In most cases, it's reversible when you stop taking the medication.
Get medical help right away if you have any symptoms of brain damage so you can get checked out. Symptoms include loss of muscle control, movement problems, changes in thoughts or behaviors, seizures, or loss of consciousness. It can also include changes in vision like blurred vision, double vision, blind spots, or a loss of vision.
Low platelet and red blood cell counts
Risk factors: History of low platelet levels | History of low red blood cell count (anemia)
It's not common, but some people who've taken cyclosporine modified (Neoral) have had low platelet and red blood cell counts. In people who've had an organ transplant, this might lead to failure of their transplant.
It isn't known what causes low platelet and red blood cell counts in these situations. But in some people, this problem got better after lowering the dose of cyclosporine modified (Neoral) or stopping the medication (along with other treatment). Tell your care team before you start this medication if you have a history of low platelet levels or anemia.
High potassium and uric acid levels
Risk factors: History of high potassium | Taking other medications that raise potassium
Some people who took cyclosporine modified (Neoral) developed high potassium levels. Tell your healthcare team if you have a history of high potassium or if you take other medications that can raise potassium levels. High potassium levels can lead to tiredness, muscle weakness, tingling or numbness, and more severely, heart problems (e.g., fast heartbeat, chest pain). Call your prescriber if you have symptoms of high potassium levels.
Harmful effects from alcohol
Risk factors: Drinking alcohol | Pregnancy | Breastfeeding | History of liver problems| History of seizures | History of alcohol use disorder | Children
Cyclosporine modified (Neoral) has some alcohol in it. Certain people should avoid taking this medication because of possible safety concerns with alcohol. Let your prescriber know if you're pregnant or breastfeeding. Also tell them if you have liver problems or seizures. Make sure they also know if you regularly drink alcohol or if you have a history of drinking a lot of alcohol. Since the alcohol in the medication can lead to serious harm in these people, your prescriber should check for your risk before you start treatment.
Cyclosporine modified (Neoral) dosage forms
Typical dosing for Cyclosporine modified (Neoral)
Generic cyclosporine modified and brand name Neoral is available as 25 mg and 100 mg soft gelatin capsules; generic cyclosporine modified also comes as 50 mg capsules. The oral solution form of the medication contains 100 mg of cyclosporine modified in each milliliter (mL).
Prevention of organ rejection after new kidney, liver, or heart transplant
Your dose will depend on the type of organ transplant, your risk of rejection, and the cyclosporine levels in your blood. It also depends on any serious side effects you have and the other transplant medications you're taking.
Kidney transplant: The typical starting dose can range from 6 mg/kg to 12 mg/kg of body weight by mouth, split into two equal doses each day.
Liver transplant: The typical starting dose can range from 4 mg/kg to 12 mg/kg by mouth, split into two equal doses each day.
Heart transplant: The typical starting dose can range from 4 mg/kg to 10 mg/kg by mouth, split into two equal doses each day.
Treatment of rheumatoid arthritis or plaque psoriasis
The typical starting dose is 2.5 mg/kg of body weight by mouth per day, split into two equal doses throughout the day. The maximum recommended dose is 4 mg/kg, split into two equal doses each day.
Interactions between Cyclosporine modified (Neoral) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bosentan
- Colchicine
- Dronedarone
- Elagolix
- Eliglustat
- Grazoprevir
- Lercanidipine
- Mifepristone
- Pitavastatin
- Simvastatin
- Sitaxsentan
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Acalabrutinib
- Aceclofenac
- Acemetacin
- Afatinib
- Alefacept
- Alfalfa
- Alfentanil
- Aliskiren
- Alprazolam
- Amifampridine
- Amlodipine
- Amtolmetin Guacil
- Aspirin
- Atorvastatin
- Avapritinib
- Bacillus of Calmette and Guerin Vaccine, Live
- Benzhydrocodone
- Berotralstat
- Betrixaban
- Black Cohosh
- Bosutinib
- Brigatinib
- Bromfenac
- Bufexamac
- Buprenorphine
- Bupropion
- Carbamazepine
- Caspofungin
- Celecoxib
- Ceritinib
- Cerivastatin
- Cholic Acid
- Choline Salicylate
- Clonixin
- Clozapine
- Cobicistat
- Codeine
- Conivaptan
- Crizotinib
- Cyclophosphamide
- Dabigatran Etexilate
- Dasabuvir
- Deflazacort
- Dengue Tetravalent Vaccine, Live
- Desogestrel
- Dexibuprofen
- Dexketoprofen
- Diclofenac
- Dienogest
- Diflunisal
- Dihydrocodeine
- Diltiazem
- Diphtheria Toxoid, Adsorbed
- Dipyrone
- Domperidone
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Drospirenone
- Droxicam
- Efavirenz
- Elexacaftor
- Eluxadoline
- Encorafenib
- Entrectinib
- Enzalutamide
- Erdafitinib
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Etodolac
- Etofenamate
- Etoposide
- Etoricoxib
- Etravirine
- Felbinac
- Felodipine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Floctafenine
- Fluconazole
- Flufenamic Acid
- Flurbiprofen
- Foscarnet
- Fosnetupitant
- Gestodene
- Glecaprevir
- Haemophilus B Vaccine
- Hepatitis A Vaccine, Inactivated
- Hydrocodone
- Hydroxychloroquine
- Ibrutinib
- Ibuprofen
- Ibuprofen Lysine
- Indomethacin
- Infliximab
- Influenza Virus Vaccine
- Isavuconazonium Sulfate
- Itraconazole
- Ivacaftor
- Ivosidenib
- Ketoprofen
- Ketorolac
- Lanreotide
- Lefamulin
- Lemborexant
- Letermovir
- Levamlodipine
- Levonorgestrel
- Lorlatinib
- Lornoxicam
- Lovastatin
- Loxoprofen
- Lumacaftor
- Lumateperone
- Lumiracoxib
- Lurbinectedin
- Lyme Disease Vaccine (Recombinant OspA)
- Measles Virus Vaccine, Live
- Meclofenamate
- Mefenamic Acid
- Meloxicam
- Meningococcal Vaccine
- Meperidine
- Mestranol
- Methadone
- Metoclopramide
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Mumps Virus Vaccine, Live
- Mycophenolic Acid
- Nabumetone
- Nafcillin
- Naproxen
- Nepafenac
- Neratinib
- Netupitant
- Nicardipine
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nomegestrol
- Norethindrone
- Norgestimate
- Norgestrel
- Obeticholic Acid
- Octreotide
- Olaparib
- Ombitasvir
- Orlistat
- Oxaprozin
- Oxycodone
- Oxyphenbutazone
- Ozanimod
- Parecoxib
- Paritaprevir
- Pazopanib
- Pemigatinib
- Pentazocine
- Perindopril
- Pertussis Vaccine
- Pexidartinib
- Phenylbutazone
- Pibrentasvir
- Piketoprofen
- Piperaquine
- Piroxicam
- Pixantrone
- Plague Vaccine
- Pneumococcal Vaccine, Diphtheria Conjugate
- Pneumococcal Vaccine Polyvalent
- Poliovirus Vaccine, Live
- Posaconazole
- Potassium Phosphate
- Pravastatin
- Proglumetacin
- Propionic Acid
- Propyphenazone
- Proquazone
- Pyrazinamide
- Rabies Vaccine
- Ranolazine
- Red Yeast Rice
- Relugolix
- Revefenacin
- Ribociclib
- Rifabutin
- Rifampin
- Rimegepant
- Ritonavir
- Rofecoxib
- Rosuvastatin
- Rotavirus Vaccine, Live
- Rubella Virus Vaccine, Live
- Salicylic Acid
- Salsalate
- Selpercatinib
- Selumetinib
- Silodosin
- Simeprevir
- Smallpox Vaccine
- Sodium Salicylate
- Sonidegib
- St John's Wort
- Sufentanil
- Sulfinpyrazone
- Sulindac
- Tacrolimus
- Tazemetostat
- Telaprevir
- Telithromycin
- Tenoxicam
- Tetanus Toxoid
- Tezacaftor
- Tiaprofenic Acid
- Tofacitinib
- Tolfenamic Acid
- Tolmetin
- Tolvaptan
- Topotecan
- Tramadol
- Tucatinib
- Typhoid Vaccine, Live
- Ubrogepant
- Valdecoxib
- Varicella Virus Vaccine, Live
- Venetoclax
- Vilazodone
- Vincristine
- Vincristine Sulfate Liposome
- Voclosporin
- Voriconazole
- Voxelotor
- Voxilaprevir
- Yellow Fever Vaccine
- Zanubrutinib
- Zoster Vaccine, Live
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetazolamide
- Allopurinol
- Ambrisentan
- Amiodarone
- Amphotericin B
- Amphotericin B Cholesteryl Sulfate Complex
- Amphotericin B Lipid Complex
- Amphotericin B Liposome
- Amprenavir
- Apixaban
- Azathioprine
- Boceprevir
- Bromocriptine
- Chloramphenicol
- Chloroquine
- Cimetidine
- Ciprofloxacin
- Cisapride
- Clarithromycin
- Clindamycin
- Clonidine
- Colesevelam
- Dalfopristin
- Danazol
- Digoxin
- Dirithromycin
- Erythromycin
- Ezetimibe
- Famotidine
- Fenofibrate
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Furosemide
- Glipizide
- Glyburide
- Imipenem
- Indinavir
- Josamycin
- Ketoconazole
- Melphalan
- Mercaptopurine
- Methotrexate
- Methylprednisolone
- Metronidazole
- Mibefradil
- Midazolam
- Miokamycin
- Modafinil
- Mycophenolate Mofetil
- Nefazodone
- Nelfinavir
- Nevirapine
- Norfloxacin
- Oxypurinol
- Phenytoin
- Probucol
- Propafenone
- Quinine
- Quinupristin
- Repaglinide
- Rifapentine
- Rivaroxaban
- Saquinavir
- Sirolimus
- Sulfadiazine
- Sulfasalazine
- Suvorexant
- Terbinafine
- Tigecycline
- Tobramycin
- Tolterodine
- Troglitazone
- Verapamil
- Warfarin
How much does Cyclosporine modified (Neoral) cost?
Cyclosporine modified (Neoral) contraindications
For all people:
Allergy to any medication containing cyclosporine
For people with rheumatoid arthritis:
Kidney problems
Uncontrolled blood pressure
Cancer
For people with plaque psoriasis:
Currently using phototherapy (PUVA or UVB therapy)
Currently taking methotrexate or other immunosuppressants
Currently using coal tar
Currently undergoing radiation therapy
Kidney problems
Uncontrolled blood pressure
Cancer
What are alternatives to Cyclosporine modified (Neoral)?
Preventing organ rejection after a kidney, liver, or heart transplant
Treating severe rheumatoid arthritis (RA)
Treating severe plaque psoriasis
Preventing organ rejection after a kidney, liver, or heart transplant
Treating severe rheumatoid arthritis (RA)
Treating severe plaque psoriasis
Kidney transplant
Liver or heart transplant - generic tacrolimus capsule and brand name Prograf only
Lung transplant - brand name Prograf only
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References
Best studies we foundAbbott Laboratories. (2000). U.S. FDA approves Abbott’s GengrafTM (cyclosporine) capsules for the prevention of organ rejection in kidney, liver and heart transplants.
American Academy of Dermatology Association. (n.d.). Psoriasis treatment: Coal tar.
Boothpur, R., et al. (2010). Human polyoma viruses and disease with emphasis on clinical BK and JC. Journal of Clinical Virology.
Centers for Disease Control and Prevention. (n.d.). PROTECT your child: Use the right tool to give the right dose.
Leukemia & Lymphoma Society. (n.d.). Lymphoma.
MedlinePlus. (2023). Transplant rejection.
MedlinePlus. (2023). Uric acid - blood.
National Kidney Foundation. (2024). Diet after kidney transplant.
National Psoriasis Foundation. (n.d.). Phototherapy for psoriasis.
Novartis Pharmaceuticals Corporation. (2024). Neoral- cyclosporine capsule, liquid filled; Neoral- cyclosporine solution [package insert]. DailyMed.
Riccardi, N., et al. (2019). Definition of opportunistic infections in immunocompromised children on the basis of etiologies and clinical features: A summary for practical purposes. Current Pediatric Reviews.
Smith Marsh, D. E. (2023). Bioequivalence and interchangeability of generic drugs. Merck Manual Consumer Version.
van Mourik, I. D. M., et al. (1999). Comparison of pharmacokinetics of Neoral and Sandimmune in stable pediatric liver transplant recipients. Liver Transplantation and Surgery.
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