Disease Information for Ciclosporine (Sandimmune) Administration/Toxicity

Clinical Manifestations
Signs & Symptoms
Brief Blood pressure increase/sign:
High blood pressure/sign
Male body habitus/female
Gum hypertrophy
Demographics & Risk Factors
Established Disease Population
Patient/Heart transplant
Patient/Liver transplant/population
Laboratory Tests
Abnormal Lab Findings - Decreased
Bicarbonate, serum (Lab)
Magnesium (Lab)
Abnormal Lab Findings - Increased
Potassium, serum (Lab)
Uric acid, serum (Lab)
Diagnostic Test Results
Other Tests & Procedures
Skin test anergy
BX/Renal Glomerular intracapillary fibrin thrombi
EMG/Myotonic muscle activity
Associated Diseases & Rule outs
Associated Disease & Complications
Acute Renal Failure
Anaphylaxis, generalized
Anergic status
Cellular immunity defect/deficiency
Drug induced Chronic Meningitis/inflammatory
Drug induced Hyperkalemia
Drug induced Hypertension.
Drug Induced Infusion Reaction
Drug induced Myopathy.
Drug induced Nephritis/Nephropathy
Drug induced Renal failure,
Drug induced Thrombocytopenia.
EBV-associated lymphoma
Gingival hyperplasia
Hemolytic-uremic syndrome
Hepatitis, alcoholic
Hypoaldosteronism Secondary/Effect
Magnesium deficiency
Meningitis, chronic
Nephritis, secondary
Opportunistic infections triggers/causes
Thrombotic thrombocytopenic purpura
Toxic nephritis/Chronic persistent
Toxic Nephritis/Nephropathy
Disease Mechanism & Classification
DRUG/Anti-Rejection Med/Organ transplant
DRUG/Blunts cytokine release/immune cells
DRUG/Calcineurin immunophilin inhibitor (ex)
DRUG/Calcium activated phosphatase/Calcineurin block
DRUG/Cytochrome p450 degradation/pharmacology (ex)
DRUG/DMARD/Disease modifying rheumatoid arthritis drug (example)
DRUG/Immune modulator drug (ex)
DRUG/Immune response modifier effect
DRUG/Immune suppressant drug (example)
DRUG/KKBP/Cyclophilin/Calcineurin Inhibitor
DRUG/Mast cell degranulation inhibitor medication (example)
DRUG/Neutrophile chemotaxis inhibited
DRUG/Prevents transplant/allograft rejection
DRUG/T-cell inhibition effect
PROCESS/Thrombotic Microangiopathy
Pathophysiology/Thrombotic microangiopathy/TMA
Pathophysiology/Osteoporosis Secondary
Pathophysiology/Defective Potassium excretion/renal
Pathophysiology/Renal afferent resistance increased
PROCESS/Medication/Drug (CONFIRM dose/before treatment)
Ciclosporin, Ciclosporin chemical, Ciclosporin product, CsA, CSA Cyclosporin A, CYA Cyclosporin, CYA Cyclosporin A, cyclosporin, Cyclosporin chemical, Cyclosporin chemical (substance), Cyclosporin A, Cyclosporin product, cyclosporine, Cyclosporine (product), Cyclosporine (substance), Cyclosporine A, CYCLOSPORINE PREPARATION, CYSP, Brand name/CsA (cyclosporine), Brand name/Neoral (Cyclosporine microemulsion), Brand name/Restasis (Cyclosporine) ophthalmic soln, Brand name/Sandimmune (Cyclosporine A), Brand name/SangCYA (Cyclosporine), Britain-BNF/Ciclosporin (Cyclosporin), Synonym/Cyclosporin (Ciclosporin)
Drug Dosage
DRUG/.$$$$$ Most Expensive
DRUG/Dose 100 mgm (Unit/Pill/Capsule size)
DRUG/Dose 25 mgm (Unit/Pill/Capsule size)
DRUG/Dose liquid/syrup/suspension form

Immunomodulator drug; Cyclic polypeptide immune suppressant drug; used in RA and tissue transplant rejection; oral preparation-------------------------

Anti-rejection drugs; Transplant patients take medications each day to prevent organ rejection; Because the patient"s immune system recognizes the new organ as a foreign tissue, it"s normal for the immune system to try to reject the organ; Drugs (called immunosuppressants) help suppress the immune system to prevent or reverse rejection; At the same time, these drugs may have side effects; Cyclosporine; Cyclosporine is one of the most frequently used anti-rejection drugs, and it is usually combined with prednisone; Cyclosporine is a very potent immunosuppressant, which patients usually have to take for the rest of their life; Cyclosporine is taken every 12 hours as capsules or a liquid; Most of our transplant patients prefer the capsule for convenience; however, the odor often leaves something to be desired! Periodically, blood samples are taken from patients to measure how much cyclosporine is in the patient"s blood, and dose changes are made so that enough drug is given to prevent rejection but not too much to prevent unwanted side effects; Common side effects may include tremors in the hands (which diminish over time), hair growth on the face or upper body, growth of the gums, headaches, blurred vision, high blood pressure, elevated potassium levels, and decreased kidney function; All immunosuppressive drugs can increase the risk of infection because they suppress the immune system; Cyclosporine interacts with many other medications; Grapefruit and grapefruit juice can cause cyclosporine blood levels to increase, so consuming these is not recommended; Transplant patients need to check with their pharmacist or transplant team before beginning new prescriptions and before purchasing non-prescription medications to ensure that the combination will not interact; In Canada, cyclosporine is only available from transplant centers so patients must always be sure that they have enough medication on hand without running out; This information as well as a list of drug interactions is available on the patient handout, "Neoral (cyclosporine) Patient Medication Information" ----------------------[london health center review 2005/google search 2006]------------------


External Links Related to Ciclosporine (Sandimmune) Administration/Toxicity
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)