Cyclosporine Frequently Asked Questions

Cyclosporine is a drug that decreases the action of the body’s immune system. It is used frequently to prevent rejection after an organ or a bone marrow transplant. It also is used to treat diseases caused by an "overactive" immune system, such as in patients who have Crohn’s disease or rheumatoid arthritis.

Cyclosporine dampens the action of the immune system, which is why it may be used to treat diseases and conditions that are thought to be immune-related. By lowering immune activity, the disease might be treated because the immune system is causing inflammation by attacking body systems and organs. This could also potentially lead to the body becoming more susceptible to infections from viruses and bacteria, which is why it will be important to discuss potential adverse effects with a healthcare provider while receiving this drug.

How Cyclosporine Is Taken

To keep a constant amount of cyclosporine in the body, it is important to take this drug at the same time each day. Not only is the time of day important, but also when cyclosporine is taken in relation to meals. Food has an effect on the absorption of cyclosporine, so cyclosporine should also be taken each day with the same association to food (i.e., either with a meal or at the same interval before or after a meal).

Missed Doses

If a dose is missed, take it as soon as it is remembered. If the next dose should be taken soon, just take that dose. Don't double up or take more than one dose at a time.

Contraindications

Tell your healthcare provider if you have any of the following conditions:

• Cancer
• High blood pressure
• Infection: viral, bacterial, or fungal
• Kidney disease
• Liver disease

Tell your healthcare provider if you have ever received treatment with the following that are sometimes combined with cyclosporine:

• Coal tar
• Methotrexate
• PUVA (Psoralen and Ultraviolet A)
• UVB (Type B Ultraviolet)

Potential Adverse Effects

Less serious side effects of cyclosporine include but are not limited to headache, diarrhea, heartburn, gas, flushing, uncontrollable shaking, muscle or joint pain, cramps, face pain or pressure, ear problems, depression, and sleep disturbance. More serious side effects include unusual bleeding or bruising, mood changes, confusion, rash, seizures, and swelling of hands, arms, feet, ankles, or lower legs.

Patients taking cyclosporine may be more vulnerable to infection. Avoid coming into contact with people who are sick with a cold, the flu, or other contagious illnesses, or those who have received the nasal flu or polio vaccine.

Sexual Side Effects

Cyclosporine is not known to cause any sexual side effects in either men or women.

Medication Interactions

Cyclosporine can interact with several drugs. Tell the prescribing healthcare provider about all drugs and nutritional supplements, especially those from the following list that may interact with cyclosporine.

• Antifungals amphotericin B (Fungizone) and ketoconazole (Nizoral)
• Bos
• Bromocriptine (Parlodel)
• Colchicine and allopurinol (Aloprim, Lopurin, Zyloprim)
• Danazol (Danocrine) and methylprednisolone (Medrol)
• Digoxin (Lanoxin, Lanoxicaps)
• HIV protease inhibitors such as indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir (Kaletra) and saquinavir (Fortovase, Invirase)
• Ketoconazole (Nizoral), itraconazole (Sporanox), and fluconazole (Diflucan)
• Macrolide antibiotics such as erythromycin (Ery-Tab, E-Mycin, E.E.S., P.C.E.) and clarithromycin (Biaxin)
• Melphalan (Alkeran)
• Metoclopramide (Reglan)
• NSAIDs such as ibuprofen (Advil, Motrin, Nuprin), naproxen (Naprosyn, Anaprox, Aleve, others), diclofenac (Voltaren, Cataflam), etodolac (Lodine), flurbiprofen (Ansaid), fenoprofen (Nalfon), indomethacin (Indocin), ketorolac (Toradol), ketoprofen (Orudis KT, Orudis, Oruvail), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin)
• Prednisolone (Prelone, Pediapred)
• PUVA or UVB therapy
• Statins: lovastatin (Mevacor), fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), or atorvastatin (Lipitor)
• Sulfa antibiotics: trimethoprim with sulfamethoxazole (Bactrim, Septra, Sulfatrim), gentamicin (Garamycin), and vancomycin (Vancocin)
• Tacrolimus (Prograf)
• Vaccinations

Potential Food Interactions

Do not take cyclosporine with grapefruit or grapefruit juice.

Safety During Pregnancy

The FDA has classified cyclosporine as a type C drug. This means it is not known whether cyclosporine will harm an unborn baby. Do not take this medication without first talking to your healthcare provider if you are pregnant or become pregnant during treatment. Cyclosporine does pass into breast milk and could affect a nursing infant.

A Word From Verywell

Cyclosporine has not often been used to treat inflammatory bowel disease (IBD) in recent years, as there are more effective choices available. Cyclosporine is sometimes given to inpatients in the hospital because it is easier to maintain drug levels that way. However, it's not often that patients with IBD will be sent home on this drug.