Sandimmun Neoral

Ciclosporin A microemulsion

Severe psoriasis in whom conventional therapy is ineffective or inappropriate.

Individualized dosage. Recommended initial dose: 2.5 mg/kg/day in 2 divided doses. If there is no improvement after 1 mth, dose may be gradually increased. Max: 5 mg/kg/day.

May be taken with or without food: Take consistently w/ regards to time of day & relation to meals. Avoid grapefruit juice. Cap: Swallow whole. Oral soln: Dilute preferably w/ orange/apple juice. Other drinks (eg, soft drinks) can also be used according to individual taste. Stir well & drink immediately.

Hypersensitivity to ciclosporin.

Increased risk of developing skin malignancies, lymphoproliferative disorders & solid organ tumours. Avoid excess UV light exposure. Predisposed to opportunistic infections. Activation of latent polyomavirus infections. Closely monitor kidney & liver function, BP & ciclosporin blood levels. Patients on K rich diet, K-sparing drugs. Monitor serum Mg levels. Hyperuricemia, impaired renal function, uncontrolled HTN/infections, any kind of malignancy. Avoid live-attenuated vaccines & concomitant UV B irradiation or PUVA photochemotherapy. Pregnancy & lactation. Elderly.

Hyperlipidaemia, anorexia, hyperuricemia, hyperkalaemia, hypomagnesaemia, tremor, headache, migraine, paraesthesia, HTN, nausea, vomiting, abdominal pain, diarrhoea, gingival hyperplasia, abnormal hepatic function, hypertrichosis, muscle cramps, myalgia, renal dysfunction, fatigue.

Decreases ciclosporin levels: Barbiturates, carbamazepine, oxcarbazepine, phenytoin; nafcillin, sulfadimidine IV, rifampicin, octreotide, probucol, orlistat, St. John's wort, ticlopidine, sulfinpyrazone, terbinafine, bosentan. Increases ciclosporin levels: Macrolides, ketoconazole, fluconazole, itraconazole, voriconazole; diltiazem, nicardipine, verapamil; metoclopramide, OC, danazol, high-dose methylprednisolone, allopurinol, amiodarone, cholic acid & derivatives, PIs, imatinib, colchicine, nefazodone. Exhibits nephrotoxic synergy: Aminoglycosides, amphotericin B, ciprofloxacin, vancomycin, trimethoprim (+ sulfamethoxazole), NSAIDs (including diclofenac, naproxen, sulindac), melphalan, H₂-blockers, MTX, tacrolimus. May increase levels of drugs that are substrates of P-gp: Digoxin, colchicine, prednisolone, statins, etoposide, aliskiren, bosentan, dabigatran, everolimus, sirolimus. May increase level of both drugs: Lercanidipine. May significantly increase serum K. May increase rate of gingival hyperplasia: Nifedipine.

Psoriasis, Seborrhea & Ichthyosis Preparations

L04AD01 - ciclosporin ; Belongs to the class of calcineurin inhibitors. Used as immunosuppressants.

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