Cyclosporine Capsule

Cyclosporine Capsules
Usage
Cyclosporine capsules are an immunosuppressant medication used to reduce immune system activity. They are commonly prescribed to prevent organ transplant rejection and to treat certain autoimmune and inflammatory conditions.
They may be used for:
• Prevention of organ transplant rejection (e.g., kidney, liver, heart)
• Severe psoriasis
• Rheumatoid arthritis
• Atopic dermatitis (severe cases)
• Other immune-mediated conditions under specialist supervision
Compounded cyclosporine capsules may be prepared when customised strengths are required.

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
• Dose may be adjusted based on blood levels, clinical response, and tolerability
• Capsules should be taken consistently with regard to meals (either always with food or always without)
• Regular monitoring is required during therapy
Patients should follow the prescriber’s instructions carefully and should not change dosing without medical advice.

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 are key mediators of immune responses.
Decreased cytokine production
Cyclosporine reduces the production of interleukin-2 (IL-2) and other cytokines, suppressing immune activity.
This leads to reduced immune-mediated inflammation and prevention of transplant rejection.

Contraindications
Cyclosporine should not be used in patients with:
• Hypersensitivity to cyclosporine or formulation components
• 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, as cyclosporine may cause nephrotoxicity
• Hypertension
• Hepatic impairment
• Increased risk of infection due to immunosuppression
• Increased risk of malignancies, particularly with long-term use
Additional considerations include:
• Regular monitoring of renal function, liver function, blood pressure, and cyclosporine blood levels is essential
• Avoid concurrent use with medicines that significantly affect CYP3A4 metabolism
• Avoid excessive exposure to sunlight or UV radiation, as immunosuppression may increase skin cancer risk
• Patients should seek medical advice if they experience signs of infection, unusual growths, or kidney-related symptoms

Storage
• Store below 25°C unless otherwise directed
• Keep capsules in a tightly closed container
• Protect from heat, moisture, and direct light
• Keep out of reach of children and pets
Patients should follow the storage instructions provided on the dispensing label supplied by the pharmacy.