Neoral (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 defence, the immune system.
Available form
Capsule, Liquid
Manufacturer
Apotex, Novartis Pharmaceuticals, Sandoz
Dosage
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The recommended dose of Neoral (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) 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.
For bone marrow transplants, the oral form of the medication is usually given as a daily dose of 12.5 mg to 15 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 transplant.
For treatment of psoriasis, the recommended oral starting dose is 2.5 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 Neoral (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 2.5 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 to a maximum of 5 mg per kilogram of body weight per day, 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 as the starting dose. The total daily 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 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 using the medication without consulting your doctor.
Swallow the capsules whole with some fluid. The oral solution should be diluted with a small amount of orange or apple juice, stirred, then swallowed immediately. Use a small amount of the juice to rinse the cup, stir, and swallow the contents again, to ensure the entire dose is taken.
It is important that Neoral (Cyclosporine) be taken exactly as prescribed by your doctor. If you miss a dose, take 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 take 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.
Store Neoral (Cyclosporine) capsules and solution at room temperature and protect from direct light. Keep the capsules in their original package until you are ready to take your dose. When the box of capsules is opened for the first time, there may be a distinct odour from the capsules. This is normal and does not mean the medication needs to be replaced.
Once the solution has been opened, it must be used within 2 months. It should not be stored below 20°C for a long period of time because a jelly-like formation may occur. If minor flakes or slight sediments are seen, the effectiveness and safety of the product and dosing will remain accurate.
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.
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*Actual pricing may differ. Medication is only available by prescription. The cost may be subsidised by your provincial or private health plan.
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