Sandimmune (Cyclosporine)

Do's

• Take it exactly as directed by your healthcare provider, typically once daily.
• Take it with or without food, but choose one way and stick to it for every dose.
• Carefully measure the dose using the provided medicine syringe, not a household spoon.
• Mix the measured dose with milk, chocolate milk, or orange juice (at room temperature) in a glass cup to improve the taste.
• Choose one type of liquid and avoid switching frequently.
• Drink the entire mixture right away, and don't prepare it in advance.
• Rinse the glass with more liquid after drinking to ensure you take all the medication.
• Dry the outside of the syringe after use, and don't rinse it with water. Clean it only if needed, and ensure it's completely dry before reuse.
• Consult your healthcare provider if you have any questions about using the medication or syringe.
• Take the medication regularly and at the same time each day for best results.

Don'ts

• Don't eat grapefruit or drink grapefruit juice unless your healthcare provider approves it.
• Don't take more than the prescribed dose.
• Don't use a household spoon for measuring.
• Don't use a plastic cup to mix the medication.
• Don't rinse the syringe with water (clean only if necessary and dry thoroughly).
• Don't stop taking Sandimmune without consulting your healthcare provider.

Common side effects:

• Drowsiness
• Insomnia
• Restlessness
• Fatigue
• Extrapyramidal symptoms
• Headache
• Weight gain
• Increased glucose
• Cholesterol abnormalities
• Temporary numbness of the mouth or tongue
• Muscle stiffness
• Nausea
• Vomiting
• Abdominal pain
• Constipation
• Dry mouth
• Increased saliva
• Increased appetite
• Tremor
• Increased heart rate
• Increased levels of prolactin
• Irregular menstrual periods
• Erectile dysfunction
• Decreased libido
• Increased risk of falls in elderly patients
• Increased risk of death in elderly patients with dementia-related psychosis
• Increased risk of stroke in elderly patients with dementia-related psychosis
• Increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults

Serious side effects that may require immediate medical attention include:

• Kidney failure
• Life-threatening infection
• Serious and sometimes fatal conditions, including cancer
• Severe brain infection that can lead to disability or death
• A virus that can cause the failure of a transplanted kidney
• Increased risk of serious infections, cancer, or transplant failure
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Serious allergic reactions
• Serious neurologic problems
• Neuroleptic malignant syndrome (NMS)
• Increased risk of developing bacterial and viral infections
• Interference with the effectiveness of vaccinations
• Hypertension (high blood pressure)
• Liver disease
• Changes in blood levels and renal function
• Hyperkalemia (high potassium levels)

This is not an exhaustive list, and other side effects may occur. If you experience any unusual or severe side effects while taking Sandimmune,  contact your healthcare provider for medical advice.

Inform your healthcare provider of any allergies you have before taking Sandimmune. This includes allergies to cyclosporine itself or any other ingredients in the medication.

Tell your healthcare provider about your medical history, particularly if you have kidney disease, liver disease, high blood pressure, cancer, skin lesions, or a history of infections. These conditions can affect how Sandimmune works or worsen side effects.

Sandimmune may cause dizziness. Avoid driving or activities requiring alertness until you know how it affects you. Limit alcohol and marijuana use which can worsen dizziness.

This medication may contain alcohol. Consult your healthcare provider if you are pregnant, breastfeeding, or have liver disease or other conditions requiring you to limit alcohol intake.

Sandimmune can weaken your immune system and increase the risk of infections. Stay away from people with contagious illnesses and tell your healthcare provider if you are exposed to an infection.

Sandimmune may increase your risk of skin cancer. Limit sun exposure and use sun protection.

Sandimmune may increase your potassium levels. Consult your healthcare provider before taking potassium supplements.

Inform your healthcare provider about all medications you take (including prescriptions, over-the-counter drugs, and herbal products) before having surgery.

Older adults may be more at risk for kidney problems or high blood pressure with Sandimmune.

During pregnancy, Sandimmune should only be used when clearly necessary. It may harm your unborn baby. Discuss the risks and benefits with your healthcare provider.

Sandimmune passes into breast milk. Consult your healthcare provider before breastfeeding.

Sandimmune weakens your immune system, increasing your risk of infections and some cancers. Tell your healthcare provider right away if you experience any signs of infection or cancer.

Sandimmune can cause high blood pressure and kidney problems. Your healthcare provider will monitor your blood pressure and kidney function while you take this medication.

If you have psoriasis and have had certain treatments in the past, you may be at increased risk for skin cancer with Sandimmune. Discuss the risks and benefits with your healthcare provider.

There are different brands of cyclosporine with varying strengths. Don't switch brands without your healthcare provider's instructions.