• Prevention of organ rejection (Kidney, liver, and heart)

• Treatment of Rheumatoid arthritis and Psoriasis

By suppressing the immune system, Sandummun Neoral 100mg Capsule helps prevent organ rejection in transplant recipients. After organ transplantation, the immune system recognizes the transplanted organ as foreign and launches an immune response to attack and reject it. Sandummun Neoral 100mg Capsule inhibits the activation of T-cells, a type of white blood cell involved in immune responses. This suppression of T-cell activity helps to prevent the immune system from attacking and damaging the transplanted organ, thereby increasing the chances of successful organ transplantation.

Taking Sandimmun Neoral 100mg Capsule (cyclosporine) with any of the following medicines can change the effect of either of them and may increase the risk of serious side effects.

1. Tacrolimus (Oral/Injection Route) Life-threatening
   Do not use together.
   Concomitant use may greatly increase the risk of kidney damage and severe immunosuppression.

2. Ketoconazole, Itraconazole, or Clarithromycin (Oral Route) Life-threatening
   Avoid unless strictly advised.
   These medicines may increase cyclosporine levels in the blood and raise the risk of kidney toxicity and high blood pressure.

3. Rifampicin (Oral Route) Life-threatening
   Do not use together.
   Rifampicin may reduce cyclosporine levels and increase the risk of organ rejection.

4. Phenytoin, Carbamazepine, or Phenobarbital (Oral Route) Life-threatening
   Avoid concomitant use.
   These medicines may lower cyclosporine levels and reduce its effectiveness.

5. St John’s Wort (Herbal Route) Life-threatening
   Do not take together.
   This herbal product may decrease cyclosporine levels and lead to transplant rejection.

6. Non-steroidal anti-inflammatory drugs such as Diclofenac (Oral Route) Moderate
   Use with caution.
   Concomitant use may increase the risk of kidney damage.

7. Potassium-sparing diuretics such as Spironolactone (Oral Route) Moderate
   Use under medical supervision.
   Taking these medicines together may increase potassium levels in the blood.

8. Live vaccines (Injection Route) Moderate
   Avoid during treatment.
   Cyclosporine weakens the immune system and may increase the risk of infection after vaccination.

• Store this medication below 30°C

• Protect the medicine from light and excessive moisture.

• Keep the medicine out of reach of children and pets

• Take only a partial dose to make up for a forgotten dose.

It is an orally available prescription drug. Your doctor will decide the dose and duration of Sandummun Neoral 100mg Capsule based on the disease condition and other factors such as body weight and age. Always take this medicine as prescribed by your doctor. Take the tablet at the same time, either with or without food. Do try to break, chew, or crush the tablet. Swallow the whole tablet with a glass of water. 

Side effects are unwanted symptoms caused by medicines. Even though all drugs cause side effects, not everyone gets them.

Serious

• Kidney damage
• Liver damage
• Infection, fever or sore throat
• Lack of coordination
• Memory problems
• Difficulty in speaking
• Visual problems
• Seizures
• Confusion
• Personality changes
• Sleeplessness
• Agitation

Common 

• Hypertension
• Electrolyte imbalance
• Increased level of potassium in the blood
• Tremor
• Abnormal hair growth
• Enlargement of gum tissues
• Low levels of magnesium
• Risk of infections
• Headache
• Gastrointestinal disturbances

• Monitor closely for infections and regularly check kidney function, liver function, blood pressure, blood cell counts, and electrolyte levels during treatment.

• Do not stop the capsule suddenly, as it may increase the risk of organ rejection in transplant patients or worsen autoimmune conditions.

• Pregnant or breastfeeding women should consult a doctor before use. Children and elderly patients need special medical supervision.

• Watch for allergic reactions, neurological symptoms, gastrointestinal issues, psychological changes, and signs of diabetes, especially if you are at risk.

• Have regular skin examinations and stay alert for any unusual lumps or changes, as there may be a risk of malignancies. Always inform your doctor about other medicines you are taking to avoid drug interactions.

1. Novartis, US Food and Drug Administration, [Revised on Sep 2009] [Accessed on 25th May,  2021], https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/050715s027,050716s028lbl.pdf
2. Novartis Pharmaceuticals UK Limited, Electronic Medicines Compendium (EMC), [Revised on March 2023] [Accessed on 25th May 2023],  https://www.medicines.org.uk/emc/files/pil.1034.pdf
3. KD Tripathi, Immunosuppressant Drugs, Essentials of Medical Pharmacology, 8th Edition, 2019,.937-945.