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In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance.
Cyclosporine is a medication that suppresses immune system function. It can help treat autoimmune conditions, including rheumatoid arthritis and psoriasis, and prevent organ rejection after a transplant.
Cyclosporine is an alternative treatment for autoimmune conditions such as rheumatoid arthritis (RA) and psoriasis. Doctors tend to prescribe it when first-line treatments have been ineffective.
Although usually effective, cyclosporine can cause various side effects. People can work with their doctor to determine whether or not this medication is the right treatment option for them.
In this article, learn more about cyclosporine, including its uses, dosage recommendations, side effects, warnings, and potential interactions with other drugs.
Cyclosporine is a prescription medication that doctors often use to treat autoimmune conditions such as RA and psoriasis. It comes in many forms, including oral capsules, an oral solution, and eye drops.
Doctors also use cyclosporine to help prevent the body from rejecting an organ after a solid organ transplant.
Autoimmune conditions develop when the immune system mistakenly attacks healthy cells. Cyclosporine works by suppressing the immune system’s responses. By reducing the immune response, the drug prevents the immune system from attacking healthy tissues. In the same way, it prevents the body from treating a transplanted organ as foreign matter.
Brand name versions of cyclosporine include:
Gengraf
Neural
Sandimmune
The immune system’s function is to fight off disease. Drugs that suppress the immune system, called immunosuppressive drugs, can make people more likely to contract infections.
Cyclosporine inhibits immune system function. Specifically, it temporarily reduces the activity of cells in the immune system called lymphocytes, such as T helper cells and T suppressor cells.
Cyclosporine also reduces how much enzyme interleukin-2 (IL-2) the body produces. IL-2 regulates white blood cell activity. Suppressing IL-2 can reduce the body’s immune response, which reduces the symptoms of autoimmune conditions.
Cyclosporine comes in various forms and dosages. People should work with their doctor to determine the best treatment option for their specific needs.
Cyclosporine is available in original or modified forms that improve how well the body absorbs the medication. As with all medications, people should take this medication in accordance with their doctor’s instructions.
People can take cyclosporine capsules (modified) or cyclosporine oral solution (modified) daily to help treat RA and psoriasis. The initial dosage is 2.5 milligrams per kilogram (mg/kg) of body weight per day, divided into two dosages. A doctor might increase this over time if necessary, up to a maximum of 4 mg/kg per day.
The initial dosage of cyclosporine for an organ transplant depends on the organ and any other medications a person is taking. People tend to continue taking cyclosporine for several weeks after the transplant.
Those with existing conditions that affect their kidneys or liver can take smaller dosages of cyclosporine. This is because this medication can cause or worsen kidney and liver issues.
Individuals who take two dosages daily should try to stick to a regular schedule. If they miss a dosage, they should take it as soon as they remember. It is important not to double up on dosages to make up for a missed one. This is because taking too much cyclosporine can result in adverse side effects.
Doctors may adjust the dosage for people with medical conditions that affect how well the body absorbs cyclosporine. These conditions can include low cholesterol or low magnesium levels.
jaundice, a yellowing of the skin and whites of the eyes that may indicate liver damage
kidney damage
swelling of the arms, hands, legs, feet, or ankles
People who think they may have taken too much cyclosporine or are experiencing symptoms of an overdose should seek immediate medical attention or call Poison Control on 1-800-222-1222.
As above, cyclosporine reduces the immune system’s function. This can increase a person’s risk of developing severe infections.
High dosages of cyclosporine can cause liver and kidney toxicity. It can also increase someone’s risk of certain types of cancer, especially lymphoma and skin cancer.
People who take immunosuppressants may have a higher risk of opportunistic infections, such as polyoma viral infections, which can have serious and sometimes fatal outcomes.
Additionally, the oral solution of cyclosporine contains a small amount of alcohol, which can negatively affect certain people.
Those who should not take the oral cyclosporine solution include children, pregnant people, breastfeeding individuals, and those who have liver disease or epilepsy.
Cyclosporine can also reduce the effectiveness of vaccines. For this reason, people may wish to consult their doctor if they plan on getting a vaccination at the same time as taking this medication.
The National Psoriasis Foundation also warns against the use of cyclosporine in people currently undergoing radiation treatment.
Although cyclosporine can help relieve the symptoms of arthritis, methotrexate remains the first-line treatment for RA. However, both treatments offer substantial benefits and side effects.
For example, methotrexate can cause skin reactions in people who spend a lot of time in the sun. It may also lead to congenital disabilities if individuals take it just before or during pregnancy.
Neoral, a form of cyclosporine, does not affect blood sugar levels. However, public health authorities do not yet consider it safe for use during pregnancy.
That said, the FDA advises that pregnant people can take this medication if the potential benefit justifies the potential risk to the fetus.
Neoral can also cause high blood pressure and kidney damage. People taking Neoral and other forms of cyclosporine may also need blood pressure medications.
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