Neoral 25mg Capsule

Uses of Neoral 25mg Capsule

• Prevents graft rejection following organ transplantation
• Treats auto-immune skin diseases such as psoriasis or atopic dermatitis
• Treats rheumatoid arthritis (joint inflammation)
• Treat nephrotic syndrome (a kidney disease)
• Treats eye inflammation (such as endogenous uveitis, including Behçet's uveitis)

How does Neoral 25mg Capsule work?

Ciclosporin is an immunosuppressive agent that blocks the release of specific immune-triggering chemicals like T-cells, interleukins, and cytokines. By doing so, it suppresses the immune system, helping the body accept a newly transplanted organ. Additionally, it halts abnormal immune responses and prevents the body from attacking its own cells.

Side Effects of Neoral 25mg Capsule

• Irritability
• Muscle tremor
• Change in mood
• Nightmares
• Anxiety
• Dizziness and Drowsiness
• Mental depression
• Nervousness
• Headache

Quick Suggestions:

• Ciclosporin is used to prevent organ rejection in transplant patients.
• It is also used to treat arthritis and immune disorders of the eyes, lungs, muscles, skin, nerves, and blood vessels.
• It may take 3 to 4 months for the medication to work. Keep taking it as prescribed.
• Your doctor may get regular blood tests done to check the levels of blood cells in your blood. Inform your doctor if you experience unexplained bruising or bleeding, sore throat, mouth ulcers, fever, or general illness. 
• Your doctor may monitor your kidney function regularly. Drink 8 to 10 glasses of water per day to help with your kidney function.
• Do not stop taking Ciclosporin without talking to your doctor first.

Indication of Neoral 25mg Capsule

Ciclosporin serves several medical purposes, including:

• Preventing Graft Rejection: It is used to prevent the rejection of transplanted organs.
• Treating Auto-Immune Skin Diseases: Cyclosporine is used to manage conditions like psoriasis and atopic dermatitis, which are characterized by an overactive immune response targeting the skin.
• Treating Rheumatoid Arthritis: It's effective in treating joint inflammation associated with rheumatoid arthritis, helping to alleviate symptoms and manage the condition.
• Treating Nephrotic Syndrome: Used in the treatment of nephrotic syndrome, a kidney disorder characterized by high levels of protein in the urine, swelling, and other complications.
• Treating Eye Inflammation: Cyclosporine is employed in cases of eye inflammation, including conditions like endogenous uveitis and Behçet's uveitis, to alleviate inflammation and manage symptoms.

These applications highlight the versatility of Cyclosporine in addressing various immune-related conditions and maintaining the health of different organs and systems in the body.

Pharmacology

Cyclosporine forms a complex with cyclophilin. This complex goes on to inhibit calcineurin, a protein that typically triggers the activation of interleukin 2 transcription. Additionally, Cyclosporine hampers the production of lymphokines and the release of interleukins. In ophthalmic applications, the exact mechanism isn't fully understood. In the context of patients with reduced tear production due to ocular inflammation related to keratoconjunctivitis sicca, Cyclosporine emulsion is believed to function as a partial immunomodulator.

Dosage & Administration of Neoral 25mg Capsule

Dosages for Neoral 25mg Capsule in different medical conditions are as follows:

Solid Organ Transplantation:

• Initially, 10 to 15 mg/kg is given in 2 divided doses, starting 12 hours before surgery.
• Continue for 1 to 2 weeks post-operatively.
• Maintenance dose: Gradually adjust to 2 to 6 mg/kg in 2 divided doses.

Bone Marrow Transplantation:

• Initially, 12.5 to 15 mg/kg is given in 2 divided doses, starting a day before transplantation.
• Maintain 12.5 mg/kg in 2 divided doses for 3 to 6 months.
• Gradually decrease to zero by 1 year after transplantation.

Endogenous Uveitis:

• Start with 5 mg/kg per day orally in 2 divided doses.
• Gradually reduce for maintenance treatment.

Nephrotic Syndrome:

• Initially, 5 mg/kg for adults and 6 mg/kg for children in 2 divided doses.
• Lower initial dose for renal impairment.
• Gradually decrease to the lowest effective level for maintenance.

Rheumatoid Arthritis:

• First 6 weeks: 3 mg/kg per day in 2 divided doses.
• Up to 12 weeks may be needed for full effectiveness.
• Adjust maintenance dose based on tolerability.

Psoriasis & Atopic Dermatitis:

• Start with 2.5 mg/kg per day in 2 divided doses.
• Use 5 mg/kg per day for rapid improvement cases.
• Titrate maintenance dose to the lowest effective level.

Directions for Use:

• Take Neoral 25mg Capsule as prescribed by your doctor.
• Swallow with a glass of water; do not crush or chew.
• Dosing is determined by your age, weight, and disease.
• Do not stop treatment without consulting your doctor.

Always follow your healthcare professional's instructions for accurate dosing and proper use of Neoral 25mg Capsule.

Interaction

Drug-Drug Interactions: Cyclosporine can interact with various other medications, including:

• Immunosuppressants like tacrolimus
• Anti-gout drugs like thiopurine
• Diuretics (water pills) like amiloride, spironolactone
• Blood pressure-lowering medications like Aliskiren
• Cholesterol-lowering drugs like atorvastatin, pitavastatin, simvastatin
• Antibiotics like erythromycin or azithromycin
• Antifungal medications like voriconazole, itraconazole
• Heart and blood pressure medications like diltiazem, verapamil, amiodarone
• Medications for menstrual problems like danazol
• Gout treatment drugs like allopurinol
• Hepatitis C treatment medications like colchicine, and telaprevir.

Drug-Food Interaction: Avoid consuming grapefruit or grapefruit juice while taking Cyclosporine, as it can impact the effectiveness of the medication.

Drug-Disease Interactions: Cyclosporine might interact with certain disease conditions:

• High blood pressure
• Liver disease
• Kidney disease

Contraindications

Neoral 25mg Capsule is not recommended for use in the following situations:

• Colitis: Inflammation of the intestine.
• Peripheral Neuropathy: Numbness and pain in hands and feet due to nerve damage.
• Porphyria: A condition involving an accumulation of porphyrin, a substance involved in making hemoglobin.
• Hemodialysis: Undergoing kidney dialysis treatment.
• Diabetes: Having diabetes.
• Gout: Experiencing high levels of uric acid.
• Liver Toxicity: Suffering from liver damage.
• Optic Neuritis: Having vision problems related to optic nerve inflammation.
• Kidney Dysfunction: Experiencing impaired kidney function.
• Liver Dysfunction: Having impaired liver function.
• Allergy: Being allergic to the medicine.

Pregnancy & Lactation

Pregnancy: There are no adequate and well-controlled studies in pregnant women and, therefore, Cyclosporine should not be used during pregnancy unless the potential benefit to the mother justifies the potential risk to the fetus.

Lactation: Cyclosporine passes into breast milk. Mothers receiving treatment with Cyclosporine should not breastfeed.

Precautions & Warnings

• Avoid taking Cyclosporine if you have an allergy to any of its components. Prior to using Cyclosporine, inform your doctor about conditions such as liver or kidney problems, high blood pressure, low magnesium levels, and elevated potassium levels.
• Be aware that Cyclosporine might increase your susceptibility to infections. Contact your doctor if you experience severe symptoms like fever, sore throat, difficulty breathing, jaundice, unexplained bleeding, or bruising.
• If you have any type of cancer, inform your doctor before taking Cyclosporine. If you are pregnant or planning pregnancy, refrain from using Cyclosporine. Breastfeeding mothers should also avoid it, as it can pass into breast milk.
• Discuss your health status and medication use with your doctor to prevent potential adverse effects. Your doctor can help ensure your safety and well-being while using Cyclosporine.

Storage Conditions

Store the Neoral 25mg Strip of 5 Capsules in a secure location inaccessible to toddlers or pets. Choose a well-ventilated room to prevent damage from heat and humidity. Refer to the label on the Neoral 25mg Strip of 5 Capsules for additional instructions.

Disposal

Properly dispose of the medicine if it's no longer needed, ensuring it doesn't pose any risk to others. Disposal guidelines provided on the packaging should be followed.