Generic Name: cyclosporine, Oral capsule

Generic Name:

cyclosporine, Oral capsule

Sandimmune

All Brands

  • Sandimmune
SECTION 1 of 5

Highlights for cyclosporine

Oral capsule
1

Cyclosporine is available as an oral capsule or oral solution.

2

Cyclosporine is an oral medication used to treat inflammation in rheumatoid arthritis and psoriasis. It’s also used to prevent the rejection of an organ transplant.

3

This medication shouldn’t be taken with other drugs that suppress your immune system. Sandimmune should be taken with corticosteroids.

4

Common side effects include high blood pressure, kidney problems, tremors, gum disease, and increased body hair.

5

Avoid excessive sunlight or tanning booths while taking this medication.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Infections. Cyclosporine may increase your risk of serious infections. It may also increase your risk of developing a tumor or skin cancer.

Skin disease. If you have the skin condition psoriasis and have been treated with either psoralen plus ultraviolet A therapy, methotrexate, coal tar, radiation therapy, or ultraviolet light therapy, you may have a higher chance of developing a skin disease while taking cyclosporine capsules.

High blood pressure and kidney disease. This medication may cause high blood pressure and kidney disease.

Liver damage warning

Taking cyclosporine may cause liver damage and liver failure, especially if you take high doses. It may even be fatal.

High potassium levels

Taking this drug may raise your potassium levels.

Risk of infection

Cyclosporine weakens the immune system. If you take this medication, you may be at greater risk for infections from bacteria, fungus, and viruses. These infections may be serious or life threatening.

Drug Features

Cyclosporine is a prescription drug. It’s available in these forms: oral capsule and oral solution.

Cyclosporine is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Why It's Used

This medication is used to prevent rejection of a transplanted organ. It’s also used to reduce inflammation in active rheumatoid arthritis (RA) and severe psoriasis.

The brand Sandimmune is only used to prevent rejection of a transplanted organ.

How It Works

Cyclosporine belongs to a class of drugs called immunosuppressants. It works by lowering your immune system, which keeps from attacking a transplanted organ or attacking your own body tissue (RA and psoriasis).

More Details

How It Works

Cyclosporine belongs to a class of drugs called immunosuppressants. It works by lowering your immune system, which keeps from attacking a transplanted organ or attacking your own body tissue (RA and psoriasis).

White blood cells normally fight substances in your body that aren’t there naturally, such as a transplanted organ. Cyclosporine stops white blood cells from attacking the transplanted organ.

Cyclosporine stops your immune system from mistakenly attacking natural substances in your body. This happens during active rheumatoid arthritis and psoriasis.

SECTION 2 of 5

cyclosporine Side Effects

Oral capsule

Most Common Side Effects

The most common side effects that occur with cyclosporine include:

  • high blood pressure

  • low magnesium levels in your body

  • blood clots in your kidneys

  • stomach pain

  • hair growth in certain areas

  • acne

  • tremors

  • headache

Serious Side Effects

If you experience any serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1. 

  • liver damage. Symptoms may include:

    • blood in urine
    • dark urine
    • pale stools
    • yellowing of your skin or the whites of your eyes
    • pain in your upper stomach
  • kidney damage. Symptoms may include:

    • blood in urine
  • heart problems. Symptoms may include:

    • swelling of your feet or lower legs
  • lung problems. Symptoms may include:

    • difficulty breathing
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Cyclosporine does not cause drowsiness.

Mild side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

cyclosporine May Interact with Other Medications

Oral capsule

Cyclosporine can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food Interactions

Avoid eating grapefruit or drinking grapefruit juice when taking this medication. It can increase the amount of cyclosporine in your body.

Medications That Might Interact with This Drug

Antibiotics

Taking cyclosporine with the following drugs may lead to higher levels of cyclosporine in your body. This may increase your risk of side effects.

  • ciprofloxacin
  • bactrim
  • azithromycin
  • clarithromycin
  • quinupristin/dalfopristin

The following drugs may decrease the amount of cyclosporine in your body. This may cause cyclosporine not to work as well as it should. This could lead to rejection of a transplanted organ when cyclosporine is used to prevent rejection.

  • nafcillin
  • rifampin

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Examples are:

  • ibuprofen
  • sulindac
  • naproxen
  • diclofenace

Taking cyclosporine with these drugs may increase your risk of kidney damage.

Antifungals

Examples are:

  • ketoconazole
  • fluconazole
  • itraconazole
  • voriconazole

Taking cyclosporine with these drugs may lead to higher levels of cyclosporine in your body. This may increase your risk of kidney damage.

Acid reflux drugs

Examples are:

  • ranitidine
  • cimetidine

Taking cyclosporine with these drugs may increase your risk of kidney damage.

Immunity suppressing drug
  • tacrolimus

Taking cyclosporine with this drug may increase your risk of kidney damage.

High cholesterol drugs

Taking cyclosporine with the following drugs may increase your risk of kidney damage.

  • fenofibrate
  • gemfibrozil

When you take cyclosporine with the following drugs, the concentration of these drugs in your body may increase. This may cause side effects such as muscle pain and weakness.

  • atorvastatin
  • simvastatin
  • lovastatin

Blood pressure drugs
  • diltiazem
  • verapamil

These drugs may increase the amount of cyclosporine in your body. This may cause harmful side effects.

Corticosteroid
  • methylprednisolone

This drug may increase the amount of cyclosporine in your body. This may cause harmful side effects.

Estrogen

This hormone may increase the amount of cyclosporine in your body. This may cause harmful side effects.

Anticonvulsants
  • carbamazepine
  • phenobarbital

This drug may decrease the amount of cyclosporine in your body. This may cause cyclosporine not to work as well as it should. This may lead to rejection of a transplanted organ when cyclosporine is used to prevent rejection.

Herb
  • St. John’s wort

This drug may decrease the amount of cyclosporine in your body. This may cause cyclosporine not to work as well as it should. This may lead to rejection of a transplanted organ when cyclosporine is used to prevent rejection.

Gout drug
  • colchicine

When cyclosporine is taken with colchicine, the amount of colchicine in the body may increase. This may increase your risks of side effects.

Hepatitis drugs
  • boceprevir
  • telaprevir

Human immunodeficiency virus (HIV) drugs
  • protease inhibitors, such as:
    • indinavir
    • nelfinavir
    • ritonavir
    • saquinavir

If you’re taking protease inhibitors HIV, check with your doctor before taking cyclosporine. Your doctor may need to reduce your dose of cyclosporine to prevent side effects.

Fluid-reducing drugs
  • triamterene
  • amiloride

Don’t take cyclosporine with these drugs. It may increase the amount of potassium in your body and may cause harmful side effects. These may include a slow heart rate, fatigue, muscle weakness, and nausea.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People kidney and liver disorders

Cyclosporine may cause kidney and liver disease. If you already have kidney or liver problems, high doses of cyclosporine may make it worse.

People with serious infections

Cyclosporine may increase your risk of serious viral infections, such as polyomavirus infection. This may be very serious and may even be fatal.

Pregnant women

Cyclosporine is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk with your doctor if you’re pregnant or plan to become pregnant. Cyclosporine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are nursing

Cyclosporine passes through breast milk and may cause serious adverse effects. Tell your doctor if you’re breastfeeding. You and your doctor need to decide if you’ll breastfeed or take cyclosporine.

Sandimmune gel-filled capsules may produce toxic effects and contain ethanol (alcohol). These may pass through breast milk and cause serious effects in a breastfeeding infant.

For Seniors

If you’re 65 years or older, you’re more likely to develop high blood pressure if you use cyclosporine. As you age, your organs, such as your liver and kidneys, don’t work as well as they once did. To prevent kidney damage, your doctor may start you on a lower dose.

For Children

Kidney, liver, or heart transplant: Children ages 1 year and older who received certain organ transplants and were treated with cyclosporine didn’t have unusual side effects.

Rheumatoid arthritis or psoriasis: The effectiveness and safety of cyclosporine haven’t been established in people younger than 18 years old who have rheumatoid arthritis or psoriasis.

SECTION 4 of 5

How to Take cyclosporine (Dosage)

Oral capsule

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Rheumatoid arthritis
Form: Oral capsule
Strengths: 25 mg and 100 mg
Adult Dosage (ages 18 years and older)
  • Dosage is based on weight.
  • The initial dose is 2.5 mg/kg per day.
  • The maximum dose is 4 mg/kg per day.
  • If you don’t get good results after 16 weeks of treatment, stop taking cyclosporine.
Child Dosage (ages 0-17 years)

Dosage hasn’t been established for people younger than 17 years old.

Special Considerations

Kidney Disorders: Cyclosporine may cause kidney disease. If you already have kidney problems, your doctor may reduce your dose of cyclosporine.

Liver Disorders: Cyclosporine may cause liver disease. If you already have liver problems, your doctor may reduce your dose of cyclosporine.

Psoriasis
Form: Oral capsule
Strengths: 25 mg and 100 mg
Adult Dosage (ages 18 years and older)
  • Dosage is based on weight.
  • The initial dose is 2.5 mg/kg per day.
  • The maximum dose is 4 mg/kg per day.
  • If you don’t get good results after 6 weeks of treatment, stop taking cyclosporine.
Child Dosage (ages 0-17 years)

Dosage hasn’t been established for people younger than 17 years old.

Special Considerations

Kidney Disorders: Cyclosporine may cause kidney disease. If you already have kidney problems, your doctor may reduce your dose of cyclosporine.

Liver Disorders: Cyclosporine may cause liver disease. If you already have liver problems, your doctor may reduce your dose of cyclosporine.

Prevent rejection of an organ transplant
Form: Oral capsule
Strengths: 25 mg and 100 mg
Adult Dosage (ages 18 years and older)

The dosage of cyclosporine may vary, depending on your body weight, the organ that has been transplanted, and other medications you’re taking.

Generic and all brands but Sandimmune:

Dosage may vary. The typical daily dose is 7–9 mg per kilogram (kg) of bodyweight taken in two even doses spaced evenly throughout the day.

Sandimmune:

  • Take your first dose 4–12 hours before your transplant. This dose is typically 15 mg/kg. Your doctor may give you a dose that’s 10–14 mg/kg per day.
  • Continue taking the same dose after your transplant surgery for 1–2 weeks. After that, reduce it by 5 percent per week to a maintenance dose of 5–10 mg/kg per day.
Child Dosage (ages 1-17 years)

The dosage of cyclosporine will vary, depending on body weight, the organ that has been transplanted, and other medications you’re taking.

Generic and all Brands but Sandimmune:

Dosage may vary. The typical daily dose is 7–9 mg per kilogram (kg) of bodyweight taken in two even doses spaced evenly throughout the day.

Sandimmune:

  • Take your first dose 4–12 hours before your transplant. This dose is typically 15 mg/kg. Your doctor may give you a dose that’s 10–14 mg/kg per day.
  • Continue taking the same dose after your transplant surgery for 1–2 weeks. After that, reduce it by 5 percent per week to a maintenance dose of 5–10 mg/kg per day.
Child Dosage (ages 0-11 months)

Dosage hasn’t been established for children younger than 1 year.

Special Considerations

Kidney Disorders: Cyclosporine may cause kidney disease. If you already have kidney problems, your doctor may reduce your dose of cyclosporine.

Liver Disorders: Cyclosporine may cause liver disease. If you already have liver problems, your doctor may reduce your dose of cyclosporine.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Cyclosporine comes with serious risks if you don't take it as prescribed.

If You Don't Take It At All

Your body may reject your transplanted organ, or your signs and symptoms of rheumatoid arthritis and psoriasis may return.

If You Stop Taking It Suddenly

Don’t stop taking this medication. If you do, your body may reject your transplant, and you may experience increased side effects. Your signs and symptoms of rheumatoid arthritis and psoriasis may return.

If You Don't Take It On Schedule

Your body may reject your transplant, causing serious health problems.  Your signs and symptoms of rheumatoid arthritis and psoriasis may return.

What to Do If You Miss a Dose

If you miss a dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose.

Don’t try to catch up by taking two doses at once. This could result in toxic side effects.

How to Tell If the Drug Is Working

You may be able to tell the drug is working if:

  • Your body doesn’t reject the transplanted organ or tissue.
  • You have fewer rheumatoid arthritis symptoms.
  • Psoriasis plaques taper off.

Cyclosporine is usually a long-term drug treatment.

Ask your doctor about how long you may need to take this treatment.

Important Considerations for Taking Cyclosporine
timing Take cyclosporine at the same time every day
do not crush Don’t crush, chew, or cut cyclosporine capsules
storage Store at room temperature: 68–77°F (20–25Cº) See Details
refillable Prescription is refillable
travel Travel See Details
clinical monitoring Clinical Monitoring See Details

Store at room temperature: 68–77°F (20–25Cº)

Keep it away from light and high temperature.

You may detect an odor when you open the container for the first time. This will disappear over time.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store them away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.
  • Don’t put this medicine in your glove compartment or leave it in the car, especially when the temperature is hot or freezing.
  • Talk to your pharmacist before you travel to be sure you have enough medicine. Depending on where you travel, you may have trouble getting this drug.

Clinical Monitoring

Your doctor may monitor you with certain blood tests before and during treatment with cyclosporine. This is to make sure it’s safe for you to take. Tests may include:

  • blood cell counts
  • liver function
  • kidney function
  • cholesterol
  • magnesium level
  • potassium level

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

Showing - out of 12
SECTION 5 of 5

How Much Does cyclosporine Cost?

Oral capsule
We've partnered with GoodRX so you can compare prices and save money on your next prescription. Check out the lowest cash prices below and enter your zip code to find the best deal near you.

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Lowest price for cyclosporine

Walgreens $65.54
CVS Pharmacy $66.70
Rite-Aid $79.88
These represent the lowest cash prices for cyclosporine and may be lower than your insurance.

Find the lowest prices of cyclosporine near you

These represent the lowest cash prices for cyclosporine and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on June 18, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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