Cyclosporine

Note: this page contains information on multiple formulations of cyclosporine.
==General information==
Class/mechanism: Cyclic polypeptide immunosuppressive agent that reversibly and preferentially inhibits T-lymphocytes, especially the T-helper cell. Exact mechanism unknown. Suppresses humoral immunity and cell-mediated immune reactions, including graft vs. host disease, allograft rejection, delayed hypersensitivity, experimental allergic encephalomyelitis, and Freund’s adjuvant arthritis. The Neoral formulation forms a microemulsion when present in an aqueous environment.
Please choose from the products below to find specific drug/manufacturer information: 
*Cyclosporine modified (Neoral)Neoral manufacturer's websiteCyclosporine modified (Neoral) package insert Cyclosporine modified (Neoral) package insert (locally hosted backup)
*Cyclosporine modified (Gengraf)Gengraf manufacturer's websiteCyclosporine modified (Gengraf oral) package insert Cyclosporine modified (Gengraf oral) package insert (locally hosted backup)Cyclosporine modified (Gengraf capsule) package insert Cyclosporine modified (Gengraf capsule) package insert (locally hosted backup)
*Cyclosporine non-modified (Sandimmune)Cyclosporine non-modified (Sandimmune) package insert Cyclosporine non-modified (Sandimmune) package insert (locally hosted backup)
Route: IV, PO
Extravasation: no information
*Sandimmune IV injection is administered at 1/3 the PO (oral) dose of Sandimmune soft gelatin capsules or oral solution. (Cyclosporine non-modified (Sandimmune) package insert PDF page 18)
*Cyclosporine modified (Neoral/Gengraf) has higher bioavailability than Sandimmune, and particularly close attention should be given to monitoring of dose levels when changing between Neoral/Gengraf and Sandimmune.
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.
==Diseases for which it is used==
*Aplastic anemia
*Castleman disease
*Hemophagocytic lymphohistiocytosis
*Myelodysplastic syndrome
==Patient drug information==
*Cyclosporine non-modified (Sandimmune) patient drug information (UpToDate)Cyclosporine non-modified (Sandimmune) patient drug information (UpToDate)
*Cyclosporine modified (Neoral) patient drug information (UpToDate)Cyclosporine modified (Neoral) patient drug information (UpToDate)
==History of changes in PMDA indication==
*2017-08-25: Revised indication and a new dosage for the treatment of aplastic anemia which is not severe.
==Also known as==
*Generic names: ciclosporin, CsA, CyA, cyclosporin, cyclosporin A
*Brand names: Sandimmune, Gengraf, Neoral
==References==
Category:Drugs
Category:Oral medications
Category:Intravenous medications
Category:Calcineurin inhibitors
Category:Aplastic anemia medications
Category:Castleman disease medications
Category:Hemophagocytic lymphohistiocytosis ‎medications
Category:Myelodysplastic syndrome medications
Category:FDA approved in 1983
Category:FDA approved in 1995