An Introduction to Your Cyclosporine Dosage
The dose of cyclosporine
) your healthcare provider recommends will vary, depending on a number of factors, including:
- The particular cyclosporine product you are using
- The reason you are using the medicine
- How you respond to it
- Your weight
- Your cyclosporine blood levels
- Other medications you are taking.
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
Cyclosporine Dosing for the Prevention of Transplant Rejection
The recommended initial dosage of regular (unmodified) cyclosporine capsules
and oral solution (Sandimmune) to help prevent an organ transplant rejection is 15 mg per kg (6.8 mg per pound) given 4 to 12 hours before transplantation. Initial doses may be as low as 10 mg to 14 mg per kg per day (4.5 mg to 6.4 mg per pound) in some people who have received a kidney transplant.
The initial dosage is usually continued for one to two weeks, and then gradually decreased by 5 percent each week to a maintenance dosage of 5 mg to 10 mg per kg per day (2.3 mg to 4.5 mg per pound). The maintenance dosage may be as low as 3 mg per kg (1.4 mg per pound) in people who have had a kidney transplant.
For modified cyclosporine
(Neoral, Gengraf), the initial dosage for preventing organ rejection is individualized based on your weight, your transplant organ, and any other anti-rejection medications you are given. Treatment is usually started 4 to 12 hours before transplant surgery, but may be started after the surgery, especially in people who have received a kidney transplant.
Regardless of which version of cyclosporine you are using, your healthcare provider will monitor you closely and adjust your dosage based on your blood levels, side effects, and response to the medicine. The goal is to find the best possible dose for you that prevents transplant rejection, while avoiding potentially serious or bothersome side effects. Your healthcare provider will attempt to find the lowest effective dosage of cyclosporine that works for you.
When used to prevent organ transplant rejection, cyclosporine is always used in combination with a corticosteroid medicine, such as prednisone
. You will be started on a high corticosteroid dose, which will be gradually reduced over a couple of months to a lower maintenance dose.
Children are generally started on the same cyclosporine doses (based on weight) as adults. However, some children may actually need higher dosages on a mg-per-pound basis.
If you are unable to take cyclosporine by mouth, you may be given the medicine as an intravenous (IV) injection. The usual initial dosage of cyclosporine IV injection is 5 mg to 6 mg per kg (2.3 mg to 2.7 mg per pound) given over two to six hours. This amount is usually continued until you are able to take cyclosporine by mouth.