It is strongly recommended that the capsules only be removed from the foil pack just prior to dosing. If one wants to open up a day s worth of Neoral, it is unlikely that it will affect the drug adversely. However, for drug stability reasons, it is not recommended that you keep capsules out of their foil pack beyond a week. It is best to avoid extremes of temperature. If Sandimmune or Neoral becomes too cool or too hot, the drug should be restored to room temperature, in order to allow it to revert to its original appearance.
Patients can, however, drink grapefruit juice at other times of the day.
Grapefruit juice doesn t increase absorption. It inhibits the activity of an enzyme in the wall of the gastrointestinal tract that is responsible for breaking down cyclosporine before it can even enter the body. There are a wide variety of drugs that can affect cyclosporine. Cyclosporine levels are individually tailored to a specific patient and therefore, there is no one target level for everyone.