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Generic Sandimmune Cyclosporine 25/100mg

Do not take this medicine with any of the following:bosentan cidofovir cisapride mibefradil ranolazine red yeast rice, monascus purpureus St. John's wort tacrolimus This medicine may also interact with the following:acyclovir allopurinol amiloride amiodarone bromocriptine carbamazepine certain antibiotics cimetidine colchicine danazol digoxin female hormones, including contraceptive or birth control pills imatinib medicines for fungal infections like amphotericin B, fluconazole, itraconazole, terbinafine, and ketoconazole medicines for blood pressure like diltiazem, nicardipine, verapamil, enalapril, ramipril, and losartan medicines for cholesterol like lovastatin, simvastatin, atorvastatin, and fenofibrate medicines for HIV infection like indinavir, nelfinavir, ritonavir, and saquinavir medicines that suppress the immune system melphalan methotrexate metoclopramide NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen octreotide orlistat oxcarbazepine phenobarbital phenytoin ranitidine sirolimus spironolactone steroid medicines like prednisone or cortisone sulfinpyrazone ticlopidine triamterene vaccines voriconazole This list may not describe all possible interactions.

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Precautions

Preliminary data indicate that when methotrexate and cyclosporine were coadministered to rheumatoid arthritis patients methotrexate concentrations (AUCs) were increased approximately 30% and the concentrations (AUCs) of its metabolite, 7-hydroxy methotrexate, were decreased by approximately 80%. During treatment with cyclosporine, vaccination may be less effective. The use of live vaccines should be avoided. Frequent gingival hyperplasia with nifedipine, and convulsions with high-dose methylprednisolone have been reported. The principal adverse reactions of Sandimmune (cyclosporine) therapy are renal dysfunction, tremor, hirsutism, hypertension, and gum hyperplasia.

Cyclosporine Drug Interactions

Pharmacodynamic interactions have been reported to occur between cyclosporine and both naproxen and sulindac, in that concomitant use is associated with additive decreases in renal function, as determined by Tc-diethylenetriaminepentaacetic acid (DTPA) and (p -aminohippuric acid) PAH clearances. Although concomitant administration of diclofenac does not affect blood levels of cyclosporine, it has been associated with approximate doubling of diclofenac blood levels and occasional reports of reversible decreases in renal function.

Overdosage

Because of the slow absorption of Sandimmune Soft Gelatin Capsules or Oral Solution, forced emesis would be of value up to 2 hours after administration. Transient hepatotoxicity and nephrotoxicity may occur which should resolve following drug withdrawal. General supportive measures and symptomatic treatment should be followed in all cases of overdosage. There is a minimal experience with overdosage. Sandimmune (cyclosporine) is not dialyzable to any great extent, nor is it cleared well by charcoal hemoperfusion. The clinical significance of this interaction is not known. The oral LD 50 is 2329 mg/kg in mice, 1480 mg/kg in rats, and greater than 1000 mg/kg in rabbits.