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NEORAL
CYCLOSPORINE MICROEMULSION - ORAL SOLUTION

Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.

CYCLOSPORINE MICROEMULSION - ORAL SOLUTION

(sye-klo-SPORE-een MY-crow-ee-MULL-shun)

COMMON BRAND NAME(S): Neoral

WARNING: Cyclosporine reduces the body's ability to fight illness/disease (immunosuppressant), leaving patients vulnerable to infection or other problems (including cancer). Using additional drugs that treat organ transplant rejection may increase these tendencies. Cyclosporine can also cause high blood pressure and kidney problems. The risk of both problems increase with increasing dose and length of therapy. Psoriasis patients who have had certain previous treatments (e.g., PUVA, UVB, coal tar, radiation therapy, methotrexate) are at increased risk to develop cancerous skin growths (malignancies). Therefore, cyclosporine must be given only under close medical supervision. Because different brands deliver different amounts of medication, do not switch brands of cyclosporine without your doctor's permission. Laboratory tests (e.g., kidney function tests, blood tests) may be performed to monitor your progress.

Uses

This medication is used to prevent or treat organ rejection in transplant patients. It is also used in certain patients with arthritis or psoriasis.

How To Use

This medication is taken orally. Take this at the same time each day and consistently with or without food. To improve the taste of the oral solution, dilute it with orange, apple, or cranberry juice. Diluting with milk may have an unpleasant taste. Twice daily, transfer the prescribed amount of medication to the cup of diluent, stir well and drink as soon as possible after mixing. Use a glass container whenever possible. Otherwise use a hard plastic cup. Do not use styrofoam cups. Rinse the cup with the juice 2 times and drink to assure all the medication is taken. Dry the outside of the dropper. Do not rinse it in water. Follow the dosing schedule for this medication carefully. If you were previously taking another brand of this medication, your dosing may be changed. Ask your doctor any question you have about your treatment.

Side Effects

This medication may cause stomach upset, nausea, cramps, diarrhea or headache. Other possible side effects include high blood pressure, increased hair growth on the face and body, acne, tremor, swollen or inflamed gums, tingling of the hands or feet. If any of these effects persist or worsen, inform your doctor. Notify your doctor if you experience: mental confusion, blurred vision, fever, sore throat, stomach pain, hearing difficulty, chest pain, urine color change, fatigue, unusual bleeding or bruising, change in the amount of urine. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, breathing trouble. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Tell your doctor your medical history, especially of: liver or kidney disease, chickenpox, herpes zoster, of all infections, blood disorders, diabetes, allergies (especially drug allergies). Cyclosporine should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk and should not be used while breast-feeding. Consult your doctor.

Drug Interactions

Tell your doctor of all prescription and nonprescription medications you may use, including: gentamicin, tobramycin, vancomycin, trimethoprim-sulfamethoxazole, cimetidine, colchicine, orlistat, quinupristin/dalfopristin, amiodarone, amphotericin B, ketoconazole, ranitidine, diclofenac, tacrolimus, diltiazem, nicardipine, verapamil, nifedipine, fluconazole, itraconazole, clarithromycin, erythromycin, methylprednisolone, allopurinol, bromocriptine, danazol, metoclopramide, nafcillin, rifampin, rifabutin, carbamazepine, phenobarbital, phenytoin, octreotide, ticlopidine, prednisolone, digoxin, triamterene, spironolactone, amiloride, birth control pills, "statin" drugs for high cholesterol, St John's wort, carvedilol, nefazodone. Do not eat grapefruit or drink grapefruit juice unless your doctor instructs you otherwise. Do not start or stop any medicine without doctor or pharmacist approval.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately.

Notes

It is important to keep regular doctor visits your progress can be monitored. Laboratory tests will be done periodically while receiving this medication.

Missed Dose

If you miss a dose, take it as soon as remembered. Do not take it if it is near the time for the next dose. Instead, skip the missed dose and resume your usual dosing schedule. Do not double the doses to catch up.

Storage

Store at room temperature 77 degrees F(25 degrees C). Do not refrigerate. Use the opened solution within 2 months. Below 68 degrees F (20 degrees C) the solution may gel and sediment may form. This does not affect the medication. Bring the solution to warm room temperature 77 degrees F (25 degrees C) to reverse the changes.

Medical Alert

Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).