Ciclosporin (Cyclosporine)

You may experience the following side effects while on Ciclosporin. Tell your doctor if you encounter any of them so that adjustments to your therapy may be made to reduce the occurrence of these side effects where possible. These include:

• Muscle cramps/pain and headaches
• Stomach discomfort, nausea and vomiting, diarrhea
• Enlarged, swollen and/or bleeding gums
• Increased hair growth
• Increased blood pressure
• Increased triglycerides (Please maintain a healthy and well-balanced diet)

Please inform your doctor if you experience any other side effects or if the side effects become severe and bothersome.

There are some potentially serious but rare side effects that may be experienced when you are using Ciclosporin. These include:

• Increased susceptibility to infections, where signs include fever, sore throats, cough or mouth ulcers
• Newly appeared moles and discolouration of skin (Avoid prolonged sun exposure and use sunscreen)
• Kidney problems, manifested as swelling of hands and feet or inability to pass urine
• Visual or hearing changes
• Severe headache and tremors

Stop using Ciclosporin and inform your doctor immediately if you experience any of the potentially serious side effects.

Do not give your child or yourself any other medications or herbal products without consulting your doctor or pharmacist. Some medication or food may reduce its efficacy, or increase the incidence of side effects where close monitoring is required. These include:

1. Grapefruit or pomelo
2. Antacids containing magnesium or aluminium hydroxide (Either take Ciclosporin either 1 hour before or 2 hours after taking antacids)
3. Bile acid sequestrants such as Cholestyramine
4. Live vaccines such as BCG, MMR, chickenpox vaccine and some forms of polio or influenza vaccines
5. Certain antibiotics or antifungals

Ciclosporin is usually taken twice a day, preferably at the same time each day.

It is important to take Ciclosporin exactly as directed by your doctor. Do not switch brands without consulting your doctor or pharmacist.

Swallow the capsules whole with a glass of water. You may take it with or without food, provided you follow the same administration method for each dose.

Do NOT administer the liquid from a plastic or styrofoam cup. Use a glass cup instead. Please use the syringe provided with the Ciclosporin bottle to measure the dose.

Push the medicine out of the syringe into a small glass with some liquid such as apple or orange juice. Avoid changing liquids frequently. Do not mix with grapefruit or pomelo juice. Avoid any contact between the syringe and the liquid in the glass. Stir and drink the entire mixture immediately.

After use, wipe the outside of the syringe with a dry tissue and replace in its case. Do not rinse the syringe before or after use. The white stopper and tube unit should remain in the bottle. Close the bottle with the cap provided.

Drugs commonly co-administered

• Corticosteroids such as Prednisolone
• Other immunosuppressants such as Mycophenolate
• Other DMARDS such as Hydroxychloroquine

Disclaimer: The list is not exhaustive, if in doubt, do inform your doctor or pharmacist especially if you are on any other medication or supplements when you are prescribed Ciclosporin.

If you forget a dose, take it as soon as you remember. If it is nearer to the time of your next dose, skip the missed dose. Do not take two doses at the same time. Please record any missed doses clearly.

Capsules should be left in the blister pack until required for use. A characteristic smell is noticeable when the blister pack is opened, but this is normal.

Discard any remaining solution in the bottle after 2 months from the date of opening.

Compliance to follow up visits

While taking Ciclosporin, you should be seeing your specialist doctor regularly to ensure that your treatment is optimized and to address any concerns relating to your treatment. Regular laboratory tests may be conducted as directed by your doctor to monitor your condition and treatment progress.

Supply of Drugs

You are advised not to purchase more Ciclosporin than required before your next visit in case of dose changes or discontinuation of therapy.

Caregiver advice

Do not give Ciclosporin to anyone else. It has been prescribed for a specific condition, and may not be the correct treatment for another person, and would be dangerous if the other person is pregnant or breastfeeding.