Sandimmun Neoral 25 mg Tablets (Ciclosporin)

Recommended Dosage of Sandimmun Neoral 25mg Tablets

The recommended initial dose of Sandimmun Neoral 25mg Tablet for various conditions is as follows:

Transplantation: Initiate therapy with 12.5–15 mg/kg given in 2 divided doses, starting on the day before transplantation.

Rheumatoid Arthritis: Start with 3 mg/kg per day orally given in 2 divided doses.

Nephrotic Syndrome: Give 5 mg/kg per day in 2 divided oral doses for adults, and 6 mg/kg per day for children.

Atopic Dermatitis: Begin with a dose range of 2.5 to 5 mg/kg per day given in 2 divided oral doses.

Warnings and Precautions of Sandimmun Neoral Tablets

Warnings:

Impaired Renal Function: Sandimmun Neoral is not recommended for patients with severely impaired renal function.
Infection Risk: Be vigilant for signs of infection and report any symptoms to your doctor immediately.
Hypertension: Since high blood pressure is a common side effect, your blood pressure should be monitored regularly.
Kidney Dysfunction: Patients with existing kidney issues should have their serum creatinine levels checked frequently.
Liver Toxicity: Keep an eye on liver enzyme and bilirubin levels to catch any signs of liver toxicity.
Lymphoma and Other Neoplasms: There’s an increased risk of certain cancers with long-term use of this medication.
Susceptibility to Infection and Skin Malignancy: This is especially a concern for patients with a history of treatments like PUVA or methotrexate.

Precautions:

Allergies: Do not use Neoral if you are allergic to it.
Kidney Disease: If you have kidney disease, Neoral may not be suitable for you.
Uncontrolled High Blood Pressure: Patients with untreated or uncontrolled hypertension should avoid this medication.
Cancer: Avoid Neoral if you have any type of cancer.
Treatment for Psoriasis: If you’re being treated for psoriasis, avoid ultraviolet light therapy (PUVA or UVB), radiation treatments, coal tar, or immunosuppressive drugs like methotrexate while receiving Neoral.

Possible Side Effects of Sandimmun Neoral Tablets

Emergency Medical Help: If you show signs of an allergic reaction, such as hives, difficulty breathing, or swelling of your face, lips, tongue, or throat, seek emergency medical help immediately.

Contact Your Doctor If You Have:

Changes in mental state, speech or walking difficulties, or decreased vision, which may worsen quickly.
Unusual bleeding or bruising, including nosebleeds or bleeding from the mouth, vagina, rectum, or purple or red spots under your skin.
Symptoms of high blood pressure like severe headache, blurred vision, pounding in your neck or ears, anxiety, confusion, severe chest pain, shortness of breath, or irregular heartbeats.
High potassium levels are indicated by nausea, slow or unusual heart rate, weakness, or loss of movement.
Kidney issues, such as reduced or absent urination, painful urination, swelling in feet or ankles, or feeling tired or short of breath.
Liver problems are marked by nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).
Signs of infection, like fever, chills, flu-like symptoms, mouth sores, skin sores, feeling light-headed or short of breath, or rapid heart rate.

Common Side Effects May Include:

Tremors or shaking.
Acne or increased growth of facial or body hair.
Elevated blood pressure.
Nausea or diarrhea.
Swollen or painful gums.

Can We Use Other Medicines with Sandimmun Neoral 25mg Tablet?

Some key drug interactions include:

Ambrisentan or Bosentan: These medications can affect how Neoral is metabolized.
Dabigatran: May increase the risk of bleeding when taken with Neoral.
Rifabutin: Can decrease the effectiveness of Neoral.
St. John’s Wort: May significantly reduce Neoral levels, leading to transplant rejection or loss of therapeutic effect.
Antibiotics or Antifungal Medications: Can either increase or decrease Neoral concentrations in your blood.
Antiviral Medications for Hepatitis C or HIV/AIDS: Can interact with Neoral, requiring adjustments in dosing.
Birth Control Pills: Certain hormonal contraceptives may have interactions.
Cholesterol-lowering Medications: Some can interact with Neoral, affecting drug levels.
Heart or Blood Pressure Medications, Including Diuretics (“Water Pills”): Can interact with Neoral, affecting kidney function and blood levels.
Seizure Medications: May decrease the effectiveness of Neoral or increase seizure activity risk.
Steroid Medications (Oral, Nasal, Inhaled, or Injectable): Can increase the risk of side effects or affect Neoral levels.

Can You Take a Sandimmun Neoral Tablet If You’re Pregnant?

When considering Sandimmun Neoral for a pregnant patient, the healthcare provider will evaluate the potential benefits against the risks of using the medication during pregnancy. Since cyclosporine, the active component of Sandimmun Neoral can be transferred to breast milk, breastfeeding while this medication is generally not recommended due to the possible effects on the nursing infant. Pregnant or breastfeeding women should have a thorough discussion with their healthcare provider about the potential risks and benefits of using Sandimmun Neoral to make an informed decision regarding their treatment.