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Sandimmune IV
Common Name
cyclosporine (intravenous)
How does this medication work? What will it do for me?
Cyclosporine belongs to the groups of medications known as immunosuppressant agents. It is used to prevent the rejection of organ transplants and bone marrow transplants by suppressing the body's natural defense, the immune system. It is also used to treat rheumatoid arthritis, which is thought to be caused by the body's own immune system attacking the joints of the body.
Cyclosporine is also used to treat severe psoriasis when other treatments have not been effective. It has also been found helpful in the treatment of a kidney condition known as nephrotic syndrome.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop receiving this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to receive this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each mL of sterile liquid contains 50 mg of cyclosporine. Ampules of 1 mL and 5 mL. Nonmedicinal ingredients: polyoxyethylated castor oil and ethanol.
How should I use this medication?
The recommended dose of cyclosporine varies according to weight and circumstances.
For solid organ transplants, the recommended dose is 10 mg to 15 mg per kilogram of body weight daily (in 2 divided doses) for the oral form, starting at least 12 hours before surgery. The dose usually stays the same for 1 or 2 weeks after the operation, and then is reduced gradually by the doctor so that a particular level of the medication in the bloodstream is reached. If you have been given the injection to start with, the doctor will likely try to switch you over to one of the oral forms of the medication.
For bone marrow transplants, the first dose is normally given by injection the day before the operation. The oral form of the medication is then usually given at a daily dose of about 12.5 mg per kilogram of body weight in 2 divided doses. This dose is usually continued for 3 to 6 months and then decreased gradually until it is stopped, about one year after the operation.
For treatment of psoriasis, the recommended oral starting dose is 2 mg per kilogram of body weight per day in 2 divided doses. If no improvement is seen in one month, the doctor may increase the daily dose gradually. The daily dose of cyclosporine should not go above 5 mg per kilogram of body weight per day. If there is still no improvement after 6 weeks of treatment, the treatment should be stopped. If the psoriasis improves, the doctor may gradually decrease the dose. Psoriasis often returns once the medication is stopped, so the goal of treatment is usually to find the smallest dose that will be effective.
For treatment of rheumatoid arthritis, the recommended dose is 2 mg per kilogram of body weight per day in 2 divided doses for the first 6 weeks of treatment. If the desired improvement is not seen, the doctor may increase the dose gradually as long as the medication is still well tolerated.
For nephrotic syndrome, the recommended starting dose is 3.5 mg per kilogram of body weight per day for adults and 4.2 mg per kilogram of body weight per day for children. People with reduced kidney function should not receive more than 2.5 mg per kg body weight per day. The dose is usually increased to a maximum of 5 mg per kilogram in adults, or 6 mg per kilogram in children. Treatment should be stopped if no improvement is seen within 3 months of starting treatment.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are receiving the medication without consulting your doctor.
It is important to receive this medication exactly as prescribed by your doctor. If you miss a dose, administer it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not administer a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
The injectable form of cyclosporine should be stored away from light at room temperature between 15°C and 30°C. It should not be frozen or put in the refrigerator.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Cyclosporine should not be used by anyone who:
- is allergic to cyclosporine or to any of the ingredients of the medication
- is being treated for psoriasis or rheumatoid arthritis who also has:
- abnormal kidney function
- any type of condition that negatively affects the function of the immune system
- cancer (except nonmelanoma skin cancer)
- uncontrolled high blood pressure
- uncontrolled infection
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- acne or oily skin
- decreased appetite
- diarrhea
- fatigue
- headache
- increase in hair growth
- muscle cramps or leg cramps
- nausea
- numbness or tingling in hands, feet, or lips
- trembling of hands
- vomiting
Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- agitation
- bleeding, tender, or enlarged gums
- confusion
- difficulty sleeping
- disorientation
- fever or chills
- frequent urge to urinate
- increased blood pressure
- irregular heartbeat
- severe nausea or vomiting
- unusual tiredness or weakness, or unexplained nervousness
- vision changes
- weakness or heaviness of legs
- weight loss
- yellowing of the eyes and skin (may indicate liver problems)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- blood in urine (may indicate kidney problems)
- flushing of face and neck
- seizures
- sign of a severe allergic reaction (e.g., swelling of the mouth, tongue, or eyes)
- wheezing or shortness of breath
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Dental health: It is particularly important to maintain good dental hygiene while you are on this medication, and to see a dentist regularly for teeth cleaning.
High blood pressure: This medication may cause high blood pressure. People taking it should have their blood pressure tested regularly.
High cholesterol: This medication may increase cholesterol. People taking it should have their cholesterol checked regularly.
Infection: This medication reduces the number of cells that fight infection in the body. This may increase your risk of developing infections and cancer, especially those of the skin and lymphoid tissue. Avoid people with infections if at all possible.
Kidney disease: Cyclosporine can have harmful effects on the kidney when taken for long periods of time.
Pregnancy: This medication should be used during pregnancy only if the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: Cyclosporine passes into breast milk and may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: Many studies have shown that children require higher doses per kilogram of body weight than adults.
What other drugs could interact with this medication?
There may be an interaction between cyclosporine and any of the following:
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If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material © 1996-2013 MediResource Inc. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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