WHAT IS CYCLOSPORINE, AND HOW DOES IT WORK?
Cyclosporine prevents organ rejection in people who have received a liver, kidney, or heart transplant. It is usually used along with other medications to allow your new organ to function normally. Cyclosporine belongs to a class of drugs known as immunosuppressants. It works by slowing down your body’s defence system (immune system) to prevent your body from rejecting a transplanted organ.
Because of the risk of severe allergic reactions from intravenous cyclosporine, it should be used only in patients who cannot take cyclosporine by mouth. Once you can take medications by mouth, you should be switched from this form of cyclosporine to either the capsules or oral solution.
Cyclosporine may also be used to prevent rejection in other organ transplants (e.g., cornea, pancreas) or bone marrow transplants. It may also be used to treat other conditions that may be helped by affecting the immune system (e.g., Crohn’s disease, ulcerative colitis).
Cyclosporine is available under the following brand names: Neoral, Sandimmune, and Gengraf.
WHAT ARE THE DOSAGES OF CYCLOSPORINE?
Dosages of Cyclosporine:
Adult and Pediatric Dosage Forms and Strengths
Capsule
- 25 mg (Gengraf, Neoral, Sandimmune)
- 50 mg (Gengraf, Sandimmune)
- 100 mg (Gengraf, Neoral, Sandimmune)
Oral solution
- 100mg/mL (Gengraf, Neoral, Sandimmune)
- Injectable solution
- 50 mg/mL (Sandimmune)
Dosage Considerations – Should be Given as Follows:
Solid Organ Transplantation
Prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants; has been used in combination with azathioprine and corticosteroids
Adjust dosage according to trough levels; general dosage guidelines are listed below
Oral
4-12 hours pre-transplant: 15 mg/kg orally for one dose
1-2 weeks post-transplant: 15 mg/kg/day orally divided twice daily
Reduce 5% per week until 5-10 mg/kg/day orally divided twice daily
Intravenous (IV)
4-12 hours pre-transplant IV: 5-6 mg/kg IV for one dose over 2-6 hours
Post-transplant, until can tolerate oral therapy: 5-6 mg/kg IV once/day
Solid Organ Transplantation, Pediatric (Off-Label)
Children as young as six months have received cyclosporine to prevent solid organ transplant rejection
Dosage is the same as adults, although children may require a higher mg/kg dose than adults
Adjust dosage according to trough levels; general dosage guidelines are listed below
Oral
4-12 hours pre-transplant: 15 mg/kg orally for one dose
1-2 weeks post-transplant: 15 mg/kg/day orally divided twice daily
Reduce 5% per week: 5-10 mg/kg/day orally divided twice daily
Intravenous (IV)
4-12 hours pre-transplant IV: 5-6 mg/kg IV for one dose over 2-6 hours
Post-transplant, until can tolerate oral therapy: 5-6 mg/kg IV once/day.