Cyclosporine Injection (patient information)

IMPORTANT WARNING
Keep all appointments with your doctor and the laboratory while taking cyclosporine, especially if your doctor changes which type (capsules or liquid) or brand (Neoral or Sandimmune) of cyclosporine you are taking.

Cyclosporine makes you more susceptible to illnesses. If you are exposed to chicken pox, measles, or tuberculosis (TB) while taking cyclosporine, call your doctor. Do not have a vaccination, other immunization, or any skin test while you are taking cyclosporine unless your doctor tells you that you may. Call your doctor if you have any injuries or signs of infection (fever, sore throat, pain during urination, and muscle aches) that occur during treatment.

About your treatment
Your doctor has ordered cyclosporine, a drug used to reduce the body's natural immune system and to prevent rejection of organ transplants (heart, kidney, liver). The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein for 2-6 hours, once every day. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how you respond to the medication.

Precautions
Before administering cyclosporine:


 * tell your doctor and pharmacist if you are allergic to cyclosporine or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking. While taking cyclosporine, do not take the following medications unless your doctor tells you to: allopurinol (Zyloprim), azithromycin (Zithromax), bromocriptine (Parlodel), carbamazepine (Tegretol), cimetidine (Tagamet), clarithromycin (Biaxin), danazol, diclofenac (Feldene), diltiazem (Cardizem), dirithromycin (Dynabac), erythromycin, fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), methotrexate, methylprednisolone (Medrol), metoclopramide (Reglan), octreotide (Sandostatin), phenobarbital, phenytoin (Dilantin), prednisolone, ranitidine (Zantac), rifabutin (Mycobutin), rifampin (Rifadin), spironolactone (Aldactone), tacrolimus (Prograf), ticlopidine (Ticlid), triamterene (Dyrenium), trimethoprim/sulfamethoxazole (Bactrim, Septra), verapamil (Calan), and vitamins.
 * tell your doctor if you have or have ever had liver or kidney disease.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cyclosporine, call your doctor.
 * you should know that this drug may make you more likely to get infections. Avoid people with contagious diseases such as the flu. Keep cuts and scratches clean. Use good personal hygiene, particularly for your mouth, teeth, skin, hair, and hands. Call your doctor immediately if you have signs of an infection such as fever, sore throat, chills, and frequent and painful urination.

Administering your medication
Before you administer cyclosporine, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Minor side effects
Cyclosporine may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:


 * upset stomach
 * vomiting
 * diarrhea
 * loss of appetite
 * increased hair growth
 * sinusitis
 * breast enlargement

Severe side effects
If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your health care provider immediately:


 * tremors
 * overgrowth of the gums
 * unusual bleeding or bruising
 * chills
 * yellowing of the skin or eyes
 * seizures
 * decreased urination
 * swelling (feet, ankles, lower legs, and hands)
 * weight gain
 * headache

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storing your medication
Your health care provider probably will give you a several-day supply of cyclosporine at a time. You may be told how to prepare each dose and how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving cyclosporine in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:


 * tenderness
 * warmth
 * irritation
 * drainage
 * redness
 * swelling
 * pain

Brand names

 * Neoral®
 * Sandimmune®
 * Sandimmune® I.V.

Other names

 * Cyclosporin A