How you should take the medicine:
Solid Organ Transplantation such as Prophylaxis of organ rejection in kidney, liver, and heart transplantation the medicine is used in combination with Azathioprine and Corticosteroids. The dose guidelines are below:

• 4-12 hour of pre-transplantation is 15 mg/kg PO for 1 dose
• 1-2 week of post-transplant is 15 mg/kg/day PO divided B/D
• Reduce 5% per week until 5-10 mg/kg/day PO divided B/D

For severe active, rheumatoid arthritis where the disease has not adequately responded to Methotrexate, may be used in combination with Methotrexate.

The dosage for it is: 1.25 mg/kg PO BID and it may increase by 0.5 to 0.75 mg/kg per day after eight weeks and again after 12 week if needed, but not to exceed 4 mg/kg per day.

Contraindications & Cautions:

• Psoriasis patients who received coal tar, Methotrexate, PUVA, or other immunosuppressants have higher risk of skin cancer with the drug Cyclosporine.
• A positive hyperkalemia and hyperuricemia may noticed having this medicine.
• If capillary leak syndrome or systemic inflammatory response suspected, tell it to your doctor or discontinue the medicine.
• Gastrointestinal and pulmonary hemorrhage if found serious and fatal, monitor platelets and coagulation parameters and treat as per the doctor’s suggestion.
• Monitor complete blood and platelet counts if Myelosuppression is noticed severe and prolonged.
• Hepatotoxicity and nephrotoxicity are some risk factors of applying Cyclospoprine.
• Gingival hyperplasia may occur, then avoid applying simultaneously Nifedipine in patients who develop gingival hyperplasia.
• Anticipate and monitor for signs and symptoms of tumor lysis syndrome occur, consult your physician for the same.
• A positive chance of optic disk edema and infusion related anaphylactic reactions by the treatment with this medicine. Therefore, consult the doctor for the same.
• With Cyclosporine, neurotoxicity may occur, particularly with high dose methylprednisolone.
• Monitor renal function and interrupt or discontinue if creatinine levels increase or acute renal failure occur.
• The patient should monitor in regular times for signs and symptoms of infection. If there is a chance of severe and fatal sepsis as a result of bone marrow suppression, the patient must discontinue the drug for a tentative chance of infection.
• Discontinue and monitor perfectly if venous occlusive disease of the liver suspected.
• Mild or moderate hypertension and rarely severe hypertension may occur. If the incidence decreases over time, then antihypertensive therapy may be required in recipients of kidney, liver, and heart transplantations treated with cyclosporine. Potassium dispensing with diuretics should not be used to treat cyclosporine associated hypertension as cyclosporine may cause hyperkalemia.  Cyclosporine metabolism may interfere with the calcium antagonists.
• Monitor liver enzymes and stop the medicine at first signs of severe hepatotoxicity, because it may be fatal.
• Seizures may occur when Cyclosporine is used in combination with high-dose corticosteroids.

Some malignancies caused by Cyclosporine immunosuppression may be fatal like lymphoma.

Storage of Cylosporine:

Store the medication at 77 degrees F or 25 degrees C. Store it away from heat, moisture, and light. Keep the medicine out of the reach of children and from pets.

Some warnings related to it:

• Cylosporine may cause dizziness or drowsiness. Alcohol or certain medicines may make the effect worse. So use the medicine with caution. The patient should not drive or perform other possibly unsafe tasks until he/she knows how he/she react to it.
• Cyclosporine is proved that it passes into breast milk. The medication is considered under pregnancy category C. So for the potential risk to the infant, breastfeeding is not recommended. Confer with your doctor before breastfeeding.
• Do not take more than the recommended dose without checking with your doctor.
• Often the symptoms most accompanying Cyclosporine’s overdose, single or in combination with other drugs have included the disorders, for it works in the central nervous system, as above mentioned. Patients should be aware that the act of Cyclosporine related to alcohol has not been studied. So, to become safe sided, patients better to avoid alcohol while taking this medicine.

Side effects related to the drug:

• Rapid weight gain, dizziness, nervousness and unusual weight gain or loss.
• Bloating or swelling of the face, arms, hands, lower legs, or feet, tingling of the hands or feet, pounding in the ears.
• Blistering, peeling, or loosening of the skin, black, tarry stools, constipation, and dark-colored urine.
• Increased sweating, fast, pounding, or irregular heartbeat or pulse, indigestion, lethargy.
• Loss of consciousness, numbness or tingling in the face, arms, or legs, pinpoint red spots on the skin.
• Severe muscle stiffness, total body jerking, sudden severe weakness, recurrent fainting.
• If you have recently undergone any kind of surgery or if you have past history of suffering from any heart problems you should check with your doctor before using Cyclosporine. The same connotes for those with a history of heart attacks, high blood pressure or any psychological illness including anxiety and depression. If you don’t think you fit into any of the categories as mentioned above, it is still a good idea to inform your doctor of any medical conditions that you may have and aware him with your medical record. Thus, you will be able to take a correct approach about it.

If any kind of such issues affect you firmly, you are strongly recommended to visit to a doctor immediately.