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Neoral (cyclosporine)

Indications

• Neoral capsules are indicated for the prevention of organ rejection in kidney, liver, and heart transplant recipients.
• Used in combination with other immunosuppressants to improve its effectiveness in preventing transplant rejection.
• Also indicated for the treatment of severe, active rheumatoid arthritis and severe, recalcitrant plaque psoriasis in patients who have failed to respond to conventional therapy.

Dosage and Administration

• Take Neoral capsules exactly as prescribed by your doctor, usually twice daily.
• Swallow the capsules whole with a full glass of water.
• Take Neoral at the same time each day to maintain consistent blood levels of the medication.
• Take a missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular schedule.
• Attend all scheduled medical appointments to monitor your response to the medication and check for side effects.
• Do not crush, chew, or split the capsules.
• Do not exceed the prescribed dose or frequency of Neoral.
• Avoid grapefruit and grapefruit juice while taking Neoral, as they can interfere with the medication’s effectiveness.
• Do not stop taking Neoral abruptly without consulting your doctor, as it may increase the risk of transplant rejection or worsening of your condition.

Mechanism of Action

Neoral contains Cyclosporine, an immunosuppressant. It works by inhibiting the activity of T-lymphocytes, a type of white blood cell involved in the immune response. This inhibition reduces the body’s ability to mount an immune response against the transplanted organ, thereby preventing rejection. In autoimmune diseases like rheumatoid arthritis and psoriasis, it helps reduce the overactive immune response that causes symptoms.

Contraindications

• Do not use Neoral if you have a known allergy to Cyclosporine or any other ingredients in the capsules.
• Avoid using Neoral if you have uncontrolled hypertension or malignancies.
• Inform your doctor if you have kidney or liver disease, uncontrolled infections, or any other significant medical conditions before starting Neoral.

Side Effects

Common Side Effects:

• High blood pressure
• Headache
• Nausea
• Diarrhea
• Tremors
• Increased hair growth
• Gum overgrowth

Serious Side Effects:

• Severe allergic reactions (rash, itching, swelling, difficulty breathing)
• Kidney problems (changes in urine output, swelling in the legs or ankles)
• Liver problems (yellowing of the skin or eyes, dark urine)
• Severe infections (fever, chills, persistent sore throat)
• Unusual bleeding or bruising
• High blood sugar (increased thirst, frequent urination)

Precautions

• Inform your doctor about any existing medical conditions or medications you are taking before using Neoral.
• Be cautious if you have a history of kidney or liver problems, high blood pressure, or infections.
• Regularly monitor blood pressure and kidney function while taking Neoral.
• Avoid excessive exposure to sunlight and UV light, as Neoral can increase the risk of skin cancer.
• If you are pregnant, planning to become pregnant, or breastfeeding, discuss the risks and benefits of Neoral with your healthcare provider.

Storage Instructions

• Store Neoral capsules at room temperature (20°C to 25°C) in a dry place, away from moisture and heat.
• Keep the capsules in their original packaging until ready to use.
• Keep Neoral Capsules out of reach of children and pets.

References

https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/050715s035,050716s038lbl.pdf