Cyclosporine (Injection)

When This Medicine Should Not Be Used

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• There are many other drugs that can interact with cyclosporine. Make sure your doctor knows about all other medicines you are using.
• Make sure your doctor knows if you are using medicines that weaken the immune system such as chemotherapy, radiation, or steroids (such as methylprednisolone, prednisolone, or Decadron®).
• Make sure your doctor knows if you are using pain or arthritis medicine (such as azapropazon, colchicine, diclofenac, naproxen, sulindac, Clinoril®, Naprosyn®, or Voltaren®), medicine for seizures (such as carbamazepine, phenobarbital, phenytoin, Dilantin®, or Tegretol®), or medicine to treat HIV or AIDS (such as indinavir, nelfinavir, ritonavir, saquinavir, Fortovase®, Invirase®, or Norvir®). Tell your doctor if you are also using melphalan (Alkeran®), tacrolimus (Protopic®), or medicine that can be hard on your kidneys.
• Make sure your doctor knows if you are using medicines to treat an infection (such as azithromycin, ciprofloxacin, clarithromycin, erythromycin, gentamicin, nafcillin, quinupristin/dalfopristin, rifabutin, rifampin, trimethoprim/sulfamethoxazole, tobramycin, vancomycin, Bactrim®, Biaxin®, Cipro®, Cotrim®, E-mycin®, Ery-tab®, Garamycin®, Mycobutin®, Nebcin®, Rifadin®, Septra®, Synercid®, Unipen®, or Vancocin®) or for fungal infections (such as amphotericin B, fluconazole, itraconazole, ketoconazole, terbinafine, voriconazole, Diflucan®, Fungizone®, Lamisil®, Nizoral®, Sporanox®, or Vfend®). Tell your doctor if you are using a stomach medicine (such as cimetidine, ranitidine, Pepcid®, Tagamet®, or Zantac®) or a blood pressure medicine (such as diltiazem, nicardipine, nifedipine, verapamil, Calan®, Cardene®, Cardizem®, Isoptin®, Procardia®, or Verelan®). Tell your doctor if you are also receiving methotrexate (Rheumatrex®) or medicine or treatment for psoriasis such as PUVA or UVB therapy.
• Make sure your doctor knows if you are also using birth control pills, medicine to lower cholesterol (such as atorvastatin, bezafibrate, fenofibrate, fluvastatin, lovastatin, pravastatin, simvastatin, Bezalip®, Lescol®, Lipitor®, Pravachol®, Tricor®, or Zocor®), allopurinol (Zyloprim®), amiodarone (Cordarone®, Pacerone®), bromocriptine (Parlodel®), danazol (Danocrine®), digoxin (Lanoxin®), imatinib (Gleevec®), metoclopramide (Reglan®), octreotide (Sandostatin®), orlistat (Xenical®), sulfinpyrazone (Anturane®), ticlopidine (Ticlid®), or St. John's wort.
• Do not take diuretics or "water pills" (such as spironolactone, triamterene, or Aldactone®) while you are using this medicine. Tell your doctor if you are using certain blood pressure medicines (such as enalapril, lisinopril, losartan, olmesartan, valsartan, Accupril®, Atacand®, Cozaar®, Diovan®, Hyzaar®, Lotrel®, or Zestril®) or any potassium supplements.
• If you are using sirolimus (Rapamune®) together with this medicine, it is recommended to use sirolimus 4 hours after receiving cyclosporine.
• Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.
• Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Bloody urine or vomit.
• Blurred vision, hearing loss, or ringing in the ears.
• Change in how much or how often you urinate.
• Chest pain.
• Confusion, weakness, uneven heartbeat, shortness of breath, or numbness or tingling in your hands, feet, or lips.
• Dark-colored urine or pale stools.
• Fast heartbeat.
• Fever, chills, cough, sore throat, or body aches.
• Nausea, vomiting, loss of appetite, or pain in your upper stomach.
• Seizures.
• Tremors or shaking.
• Unusual bleeding, bruising, or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Acne, or hair growth on your face, chest, hands, or legs.
• Diarrhea, nausea, vomiting, or stomach discomfort.
• Headache.
• Runny or stuffy nose.
• Swelling of your gums.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

How to Use This Medicine

Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
• A nurse or other trained health professional will give you this medicine.
• Your doctor will give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Introduction

Cyclosporine (sye-kloe-SPOR-een)

Used with other medicines to prevent organ rejection after kidney, liver, or heart transplant surgery.

Brand Name(s)

Sandimmune

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant, or if you have kidney disease, liver disease, anemia, bleeding problems, brain disease, high blood pressure, eye or visual problems (such as papilloedema), or a history of seizures (epilepsy).
• This medicine may increase your risk of developing skin cancer or blood cancer. Talk to your doctor if you have concerns about this risk.
• This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you get the injection.
• This medicine may increase your risk of developing a rare and serious virus infection called BK virus-associated nephropathy (BKVAN). The BK virus may affect how your kidneys work and cause a transplanted kidney to fail. Check with your doctor right away if you are having more than one of these symptoms: bloody urine; a decreased frequency or amount of urine; increased thirst; loss of appetite; lower back or side pain; nausea; swelling of the face, fingers, or lower legs; trouble with breathing; unusual tiredness or weakness; vomiting; or weight gain.
• This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
• Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.