Ciclosporin (cyclosporin)

How do I take ciclosporin?

Ciclosporin is usually taken twice a day.

Capsules should be taken with water and then be swallowed whole. The oral solution should be diluted immediately before being taken. This can be diluted for improved taste with water, squash, orange or apple juice, and should be stirred well.

Avoid grapefruit juice while taking the drug as this interferes with ciclosporin. 

Ciclosporin is available at Moorfields Eye Hospital under the brand name Neoral®, which comes as 10mg (yellow/white), 25mg (blue/grey), 50mg (yellow/white) and 100mg (blue/grey) capsules; and 100mg/ml oral solution (yellow, sugar-free). Your doctor will prescribe the appropriate dose for you and will adjust the dose accordingly to achieve the best result. Ensure you always take the same brand of ciclosporin capsules unless it is an informed change introduced by your doctor.

Can I carry on taking my other medications?
Due to the potential risk of the drug interacting with other medicines, you should inform your doctor and/or pharmacist about any medication you are currently taking, or any new medicines you have been prescribed. This includes any medications bought from the pharmacy without a prescription as well as herbal and complementary medicines (e.g. St. John’s Wort).  Avoid over the counter NSAID’s such as ibuprofen and diclofenac. You should also inform us if you are allergic to ciclosporin or any other medication.

Which tests will I need and how often will I need them?

It is very important that you are regularly checked whilst using ciclosporin.

A blood test is usually needed every two weeks for six weeks, then monthly thereafter. This may vary depending on your condition. Your weight, blood pressure, cholesterol and blood sugar will also be checked regularly. It is your responsibility to ensure that you have your blood tests on time. It is important that you do not miss these and that you do not take ciclosporin unless you are having blood tests regularly.

What else do I need to be aware of before taking ciclosporin?

Previous medical issues

Before starting ciclosporin you should tell us if you have any kidney or liver problems, hypertension, cancer, or skin disorders.

You must also inform us if you have a weak immune system or a tendency to catch infections easily.

Pregnancy, contraception and breast-feeding

Due to a potential risk to the foetus, you should use effective contraception whilst on ciclosporin, and for three months after stopping the drug. Please inform your doctor as soon as possible if you plan to become pregnant or think that you may be pregnant.

Ciclosporin passes into breast milk, therefore please inform your doctor if you are breast-feeding and on treatment. You may be advised to stop breast-feeding whilst on treatment.

Viral infections and vaccinations

Your body’s resistance to infection can be reduced whilst you are taking ciclosporin. Therefore, you should avoid close contact with people who have viral infections, in particular chicken pox or shingles. If you develop either of these, you should inform your doctor immediately. You should also ask your doctor or pharmacist before having any vaccinations.

You may also be more at risk of catching infections of the skin, mouth, stomach and intestines, lungs and urinary tract. Please inform your doctor about any symptoms of infection which last for more than three days (for example, sore throat, cough, fever).

Food preparation

Cooked chilled foods should be reheated thoroughly, and salads washed well; avoid ready-prepared supermarket salads. Avoid raw seafood and soft cheese made from unpasteurised milk.

Alcohol

You are advised not to drink more than 14 units of alcohol per week, spread evenly over three or more days, on a regular basis. 14 units is equivalent to six pints of average-strength beer or 10 small glasses of low-strength wine.

Sun exposure

Take care to avoid too much sun (including sun beds) whilst taking this medicine and use a sunscreen with a high protection factor e.g. SPF 50.

What are the side effects?

As with most medicines, ciclosporin may cause side-effects although this is not the case for everyone.

Possible side-effects include:

• Unusual hair growth.
• Tremor (e.g. shaking hands).
• High blood pressure.
• General tiredness and headache.
• Nausea and vomiting.
• Abdominal pain and diarrhoea.
• Gum overgrowth.

Tingling (especially in hands and feet) may also occur, usually within the first week of treatment).

Ciclosporin may also increase the risk of kidney damage and reduce levels of certain types of blood cells. You should stop taking ciclosporin and seek medical advice immediately if you experience any of the following:

• Symptoms such as bruising or rash.
• Change in colour and amount of urine.
• Long-lasting, unusual changes in behaviour.

Need more information?

Please refer to the leaflet included with the medicine for further information, or contact the pharmacy department on: 020 7566 2362.