How to use
Cyclosporine should be taken orally, once or twice a day, at approximately the same time every day. You can take Cyclosporine with or without food but it is important to take this medication the same way each time. If you choose to take Cyclosporine with a meal, you should make sure to take every dose with the same type of food. Swallow the tablets whole and do not chew or crush them. It is equally important to take Cyclosporine at evenly spaced intervals to ensure there is a constant level of this medication in your blood stream at all times.

Your doctor will determine which dosage is best for you, depending on various factors, such as your height, weight, age, general health and the condition being treated.

Overdose
Possible side effects of a Cyclosporine overdose include:

• Nausea
• Vomiting
• Pain in the upper stomach
• Loss of appetite
• Jaundice (yellowing of the skin or eyes)
• Urinating less than usual or not at all

If you suspect you have taken too much of this medication, please contact your local poison control center or emergency medical services immediately.

Missed dose
If you miss a dose of Cyclopsorine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not try to make up for a missed dose by doubling up.

Notes
Your doctor may want to perform regular tests and medical check-ups to see how you are responding to Cyclosporine and if there are any unwanted side effects. You should also have your blood pressure regularly monitored.

Do not share this medication with others, as they may have a problem that is not effectively treated by this drug.

If you’ve recently had an organ transplant, it is highly recommended you attend a transplant education class or support group.

Storage
Store Cyclosporine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C), away from heat and moisture. KEEP THIS AND ALL OTHER MEDICATION OUT OF REACH OF CHILDREN.

Important note
The above information is intended to supplement, not substitute for, the expertise and judgement of your physician, pharmacist or other healthcare professional. It should not be construed that the taking of this medication is safe, appropriate or effective for you.

 * Illustrations are for graphic purposes only and the ordered medication may differ in appearance.

Precautions
Before taking Cyclosporine, inform your doctor of your medical history, especially of:

• Any allergies
• Any vaccinations
• A history of chickenpox or shingles
• Uncontrolled high blood pressure
• Cancer
• Skin lesions of unknown cause
• Current use of radiation therapy (including phototherapy with PUVA or UVB)
• Kidney or liver diseases
• Any recent or current infections
• Seizures
• Untreated mineral imbalance (e.g. low magnesium or high potassium)
• Blood disorders
• Diabetes
• High cholesterol

Cyclosporine is classed as FDA Pregnancy Category C, which means it is not yet known if it can be harmful to an unborn baby. Inform your doctor immediately if you are pregnant or become pregnant during treatment with Cyclosporine.
Do not use this medication while breastfeeding. Cyclosporine may pass into breast milk and could potentially harm a nursing infant. If you are breastfeeding and want to start treatment with Cyclosporine, contact your doctor immediately.

Cyclosporine may reduce the levels of magnesium in the blood stream. You should talk to your doctor about adding more magnesium to your diet.

Using Cyclosporine may cause swelling and growth of the gums (gingival hyperplasia). Brush your teeth and floss daily to minimize this problem and visit your dentist regularly.

Cyclosporine reduces the actions of your immune system and can therefore cause serious infections. Make sure you maintain a good personal hygiene while taking Cyclosporine.

Patients who take immunosuppressive medication in the long term are at increased risk of skin cancer. Avoid exposure to strong sunlight and wear a good sunscreen or protective clothing.

Drug Interactions
Before taking Cyclosporine, you should inform your doctor if you take any of the following:

• Birth control pills
• Carvedilol
• Caspofungin
• Digoxin
• Etoposide
• Ezetimibe
• Other immunosuppressants (e.g. Azathioprine, Methotrexate, Sirolimus)
• Acyclovir, Aminoglycoside
• Antibiotics including Tobramycin, Amphotericin B, Colchicine
• Fibrates including Fenofibrate
• Melphalan
• NSAIDs including Diclofenac and Sulindac
• Ranitidine
• Sulfa drugs including Sulfamethoxazole
• Vancomycin
• Allopurinol, Amiodarone, Azole)
• Antifungals (including Fluconazole and Ketoconazole)
• Barbiturates including Phenobarbital, Bromocriptine
• Calcium channel blockers including Diltiazem, Nicardipine and Verapamil
• Cimetidine
• HIV protease inhibitors including Indinavir, Imatinib
• Macrolide antibiotics including Erythromycin
• Certain man-made male hormones such as Danazol and Methyltestosterone
• Methylprednisolone
• Metoclopramide
• Metronidazole
• Nafcillin
• Nefazodone
• Octreotide
• Quinupristin, Dalfopristin
• Rifamycins including Rifampin
• Certain anti-seizure drugs including Carbamazepine and Phenytoin
• St. Johns wort
• Ticlopidine
• Nifedipine
• Orlistat
• Certain Guinolones (Ciprofloxacin, Norfloxacin)
• Repaglinide
• Other statins (Atorvastatin)
• Sulfinpyrazone
• Temsirolimus
• Terbinafine
• Tolterodine
• Drugs that may increase potassium levels (e.g. ACE inhibitors including Lisinopril, ARBs including Losartan, potassium supplements, diuretics including Amiloride and Spironolactone

The above is only a partial list and other medications may interact with Cyclosporine. Inform your doctor of all other prescription and over-the-counter medicines you use, including vitamins, nutritional supplements, herbal pills and medication prescribed by another doctor. Do not change medications without talking to your doctor first.

When taking Cyclosporine, you may notice any of the following common side effects:

• Tremors or shaking
• Increased hair growth
• Headache or body pain
• Diarrhea, constipation, vomiting
• Numbness or tingly feeling
• Acne
• Swollen, red or painful gums
• Dizziness, flushing
• High blood pressure

Notify your doctor immediately if you experience any of these serious side effects:

• Urinating less than usual or not at all
• Drowsiness, confusion, mood changes, increased thirst
• Swelling, weight gain, feeling short of breath
• Blurred vision, headache or pain behind your eyes, sometimes with vomiting
• Seizure (convulsions)
• Muscle pain or weakness, fast heart rate, feeling light-headed
• Signs of infection such as fever, chills, sore throat, flu symptoms
• Pale skin, easy bruising or bleeding, unusual weakness
• Nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
• Fast or irregular heartbeat
• Unusual weight loss or gain
• Hearing problems
• Changes in the appearance of skin moles or lesions
• Swollen glands or unusual lumps

Seek immediate medical help if you experience any of the following signs of an allergic reaction to Cyclosporine:

• Hives
• Difficulty breathing
• Swelling of the lips, face, tongue or throat

This is only a partial list of possible side effects and others may occur. Contact your healthcare provider immediately if any other side effects occur than the ones listed above or if they are especially bothersome.