Precautions and Warnings With Cyclosporine

Specific Cyclosporine Precautions and Warnings

Some warnings and precautions to be aware of before taking this medication include the following:
  • You must take this medicine under the direction of a healthcare provider who has experience prescribing medications that suppress the immune system and, if you have received an organ transplant, in treating people who have undergone organ transplantation.
  • Cyclosporine weakens your immune system, which increases your risk for getting an infection. It may also take your body longer to recover from infection. You could become infected with the BK virus while taking this medicine, a virus that can damage your kidneys after a kidney transplant. Contact your healthcare provider right away if you develop signs of an infection, such as fever, body aches, or chills, or if you develop sores on your skin that do not heal.
  • This medication increases your risk for developing skin cancer and lymphoma (cancer of the lymph nodes). Your risk may be even higher if you take other medicines that weaken the immune system or if you have psoriasis and have received certain other treatments before cyclosporine.
You should limit your time in the sun during cyclosporine treatment. When you are out in the sun, wear sunscreen with a sun protective factor (SPF) of at least 30 and protective clothing, such as hats, long pants, and long sleeves. Contact your healthcare provider if you notice any skin changes or develop lumps in your neck, underarm, or groin area.
  • You will need regular blood tests and blood pressure monitoring during treatment. Your healthcare provider may also want to check your cyclosporine blood levels. People who take cyclosporine for psoriasis or rheumatoid arthritis will need blood tests and blood pressure monitoring before starting treatment. Make sure to keep all your healthcare and laboratory appointments.
  • If you get a vaccination while taking cyclosporine, the vaccination may not be as effective. In addition, people taking cyclosporine should not receive "live" vaccines (see Drug Interactions With Cyclosporine). Check with your healthcare provider before getting any vaccination while taking this medication.
  • Cyclosporine comes in an original form (Sandimmune) and a modified form (Neoral, Gengraf). These two types of cyclosporine are absorbed differently by the body, and are therefore not interchangeable. If you receive a prescription for cyclosporine that looks unfamiliar to you, talk to your pharmacist or healthcare provider to make sure you have received the correct type of cyclosporine. You should only switch types of cyclosporine under the direction of a healthcare provider. You may need a dose adjustment after the switch.
  • This medicine can damage your kidneys and liver, especially when used in high doses or for extended periods. It can also cause high blood pressure. Your healthcare provider will monitor you for these side effects during treatment.
  • Cyclosporine may cause high blood pressure and high levels of potassium in the blood (hyperkalemia). It can also increase the amount of uric acid in your blood, which could cause kidney stones or gout (a type of arthritis that affects the joints, especially of the toe).
  • There have been reports of seizures in people taking cyclosporine, especially when used in combination with methylprednisolone (A-Methapred®, Depo-Medrol®, Medrol®, Solu-Medrol®). There have also been reports of encephalopathy, a medical term for a disease of the brain that causes altered brain function. Seek immediate medical care if you experience signs of encephalopathy, such as:
    • Confusion
    • Vision changes
    • Muscle weakness
    • Problems with movement
    • Seizures.
  • Cyclosporine passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Cyclosporine and Breastfeeding).
  • Cyclosporine is a pregnancy Category C medication, which means it may not be safe for use during pregnancy. If you are pregnant or thinking of becoming pregnant, talk to your healthcare provider prior to taking this medicine (see Cyclosporine and Pregnancy).
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