Cyclosporine Dosage

Cyclosporine Dosing for Rheumatoid Arthritis

The usual initial dosage of modified cyclosporine (Neoral, Gengraf) for the treatment of rheumatoid arthritis is 1.25 mg per kg (0.57 mg per pound) taken twice a day. It normally takes four to eight weeks for the medicine to start working to relieve symptoms. Unmodified cyclosporine (Sandimmune) is not approved for this use.
 
If your symptoms are not adequately controlled after eight weeks of treatment and you are tolerating the medicine, your healthcare provider may increase your dose by 0.5 mg to 0.75 mg per kg per day (0.23 mg to 0.34 mg per pound). If needed, this amount may be increased further. The maximum recommended dosage for treating rheumatoid arthritis is 4 mg per kg per day (1.8 mg per pound).
 
It is generally recommended that treatment be stopped if no benefit is seen within 16 weeks. Your healthcare provider may also recommend you stop taking cyclosporine, or reduce your dosage, if you experience potentially serious side effects at any time during treatment.
 

Cyclosporine Dosing for Psoriasis

The initial recommended dose of modified cyclosporine (Neoral, Gengraf) for the treatment of psoriasis is usually 1.25 mg per kg twice a day (0.57 mg per pound). If your psoriasis is not adequately controlled after four weeks of treatment, your healthcare provider may begin to slowly increase your dosage until an adequate response is observed, serious or bothersome side effects occur, or you reach the maximum recommended dose of 4 mg per kg per day (1.8 mg per pound). Unmodified cyclosporine (Sandimmune) is not approved for this use.
 
You may notice some improvement in your condition within two weeks of starting treatment; however, it may take 12 to 16 weeks for a complete response. It is generally recommended that treatment be stopped if an adequate response is not achieved after six weeks of treatment at the highest tolerated dose (up to a maximum recommended dose of 4 mg per kg per day).
 
Once you have achieved an adequate response, your healthcare provider may attempt to lower your dosage to find the lowest effective dosage for you.
 
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