Cyclosporine Suspension

Cyclosporine Suspension
Usage
Cyclosporine suspension is an oral liquid formulation of an immunosuppressant medication used to reduce immune system activity. It is particularly useful for patients who require individualised dosing or have difficulty swallowing capsules, including paediatric patients.
It may be prescribed for:
• Prevention of organ transplant rejection (e.g., kidney, liver, heart)
• Autoimmune conditions, such as rheumatoid arthritis or severe psoriasis
• Severe atopic dermatitis
• Other immune-mediated disorders under specialist supervision

Dosage
Dosage should be determined by the prescribing specialist based on the patient’s condition, body weight, and response to therapy.
Typical dosing considerations include:
• Usually administered once or twice daily
• Dosing is often based on body weight (mg/kg/day)
• The suspension should be shaken well before use
• It should be taken consistently with regard to meals (either always with food or always without)
• Dose adjustments may be required based on blood cyclosporine levels and clinical response
Regular monitoring is essential during therapy.

Mechanisms of Action
Cyclosporine is a calcineurin inhibitor that suppresses immune responses.
Its mechanisms include:
Inhibition of calcineurin
Cyclosporine binds to intracellular proteins (cyclophilins), inhibiting calcineurin activity.
Reduction of T-cell activation
This prevents activation of T-lymphocytes, which play a key role in immune responses.
Decreased cytokine production
Cyclosporine reduces production of interleukin-2 (IL-2) and other cytokines.
This results in suppression of immune-mediated inflammation and prevention of transplant rejection.

Contraindications
Cyclosporine suspension should not be used in patients with:
• Hypersensitivity to cyclosporine or any component of the formulation
• Certain conditions where immunosuppression is inappropriate
• Uncontrolled infections
• Certain malignancies, unless under specialist supervision

Precautions
Cyclosporine should be used with caution in patients with:
• Renal impairment, due to risk of nephrotoxicity
• Hypertension
• Hepatic impairment
• Increased susceptibility to infections
• Increased risk of malignancies, especially with long-term use
Additional considerations include:
• Regular monitoring of renal function, liver function, blood pressure, and cyclosporine levels is required
• Avoid concurrent use with medications that significantly affect CYP3A4 metabolism
• Avoid excessive sun exposure or UV therapy, due to increased risk of skin cancer
• Patients should seek medical advice if they experience signs of infection, kidney dysfunction, or unusual growths

Storage
• Store below 25°C unless otherwise directed
• Keep the suspension in a tightly closed container
• Shake well before use
• Protect from heat, moisture, and direct light
• Some formulations may require refrigeration, depending on compounding instructions
• Keep out of reach of children and pets
Patients should follow the specific storage instructions provided on the dispensing label supplied by the pharmacy.