Cyclosporine Oral Capsules and Solution for Transplant and Autoimmune Care

What Cyclosporine Is and How It Works

Cyclosporine is a calcineurin inhibitor used to prevent organ transplant rejection and to treat select autoimmune diseases such as severe psoriasis and rheumatoid arthritis. This cyclosporine medicine is available as oral cyclosporine capsules and oral solution. Dosing is usually twice daily to maintain stable blood levels.

Cyclosporine reduces T‑cell activation by blocking calcineurin, which lowers interleukin‑2 (IL‑2) production. The effect helps protect a transplanted organ and can calm overactive immune responses in dermatologic and rheumatologic conditions. Modified cyclosporine products have improved absorption versus the original formulation.

CanadianInsulin is a prescription referral service. Prescriptions are verified with your clinic, and orders are filled by licensed Canadian pharmacies.

We work with licensed, vetted partner pharmacies to supply authentic brand medications and generics, with a broad selection and value‑focused pricing.

Two cyclosporine formulations exist: non‑modified (e.g., Sandimmune) and modified (e.g., Gengraf/Neoral). They are not bioequivalent. Do not switch between cyclosporine modified and non‑modified products unless the prescriber directs and monitoring is arranged.

This page addresses systemic, oral cyclosporine. Cyclosporine ophthalmic 0.05% is a topical eye product for dry eye and is not interchangeable with oral therapy.

Dosage and Usage

• Follow the exact prescription and lab monitoring plan provided by the care team.
• Take cyclosporine at the same times each day, about 12 hours apart.
• Be consistent with meals. Take either always with food or always without food.
• Swallow cyclosporine capsules or cyclosporine tablets whole. Do not crush or chew.
• Common strengths include cyclosporine 25 mg and cyclosporine 100 mg capsules.
• For transplant prophylaxis, initial doses are higher, then tapered to maintenance based on trough levels and kidney function.
• For psoriasis or rheumatoid arthritis, typical starting doses are lower, with cautious increases if needed, and regular monitoring.
• Modified and non‑modified products use different dosing. Do not substitute one for the other outside supervised conversion.
• Missed dose: take it when remembered unless it is close to the next dose. Do not double doses.
• Avoid grapefruit and grapefruit juice. Do not use St. John’s wort. These can change cyclosporine levels.
• Limit nephrotoxic drugs when possible (e.g., high‑dose NSAIDs, aminoglycosides). Discuss all medicines and supplements with a clinician.

• Storage: store at 20–25°C (68–77°F). Short excursions 15–30°C (59–86°F) are acceptable.
• Keep capsules in original packaging to protect from moisture and light.
• Do not freeze. Protect the oral solution from heat and light; check the label for use‑by guidance after opening.
• Travel: keep medicine in carry‑on luggage. Use a travel pill case that stays dry. Avoid hot cars and direct sun.
• If a dose must be mixed (oral solution), follow the product instructions. Mix only with allowed liquids and take immediately.

Benefits and Savings

Cyclosporine has decades of evidence for preventing rejection after kidney, liver, and heart transplants. In severe plaque psoriasis and rheumatoid arthritis, it can reduce flares and improve function when other therapies are inadequate. Modified cyclosporine improves absorption, aiding steadier trough levels.

Oral dosing is familiar and flexible, with cyclosporine capsules and liquid options. Therapeutic drug monitoring helps personalize exposure while watching kidney function and blood pressure. Generic cyclosporine offers broad availability and selection across strengths.

Many customers save 60–80% vs typical U.S. prices.

See our promotions page for current offers, including any cyclopsorine discount if available.

Side Effects and Safety

• Common: tremor, headache, nausea, diarrhea, abdominal discomfort.
• Kidney effects: increased creatinine, decreased GFR, hyperkalemia.
• Blood pressure elevation; may require antihypertensive therapy.
• Metabolic: hyperlipidemia, hyperuricemia, hypomagnesemia.
• Dermatologic: hirsutism, acne, flushing.
• Gingival hyperplasia; improve dental hygiene and routine cleanings.

Serious risks include nephrotoxicity, hepatotoxicity, severe infections, and malignancies (especially lymphomas and skin cancers). Black box warnings highlight infection and cancer risks. Posterior reversible encephalopathy syndrome (PRES), seizures, and anaphylactoid reactions (mainly with IV) can occur. Vaccinations with live vaccines should be avoided during therapy. Risk of myopathy increases with certain statins. Hypoglycemia risk is not typical but monitor closely if combined with agents that affect glucose. Seek urgent care for severe neurologic symptoms, signs of infection, or marked blood pressure changes.

Onset Time

After oral dosing, cyclosporine absorption begins within hours, and therapeutic levels are guided by trough monitoring. In transplant recipients, protective immunosuppression is active once target levels are achieved over the first days. In psoriasis or rheumatoid arthritis, clinical improvement may appear within 4–8 weeks, with maximal benefit often seen by 12–16 weeks as dosing stabilizes.

Compare With Alternatives

Tacrolimus is another calcineurin inhibitor often used after organ transplant. It is taken twice daily or as an extended‑release product. Compared with cyclosporine, tacrolimus may cause more neurotoxicity and diabetes risk but less hirsutism and gingival hyperplasia. Selection depends on organ type, comorbidities, and prior response.

Sirolimus (an mTOR inhibitor) can replace or complement calcineurin inhibitors in some regimens, especially when nephrotoxicity limits therapy. It has different metabolic effects and requires distinct trough targets. Mycophenolate mofetil is widely used with either calcineurin inhibitor to reduce rejection risk.

For context on immune‑based therapies, see Beyond Insulin The Promise Of Immunotherapy In Type 1 Diabetes Treatment.

Note: cyclosporine brand names include Gengraf (modified) and Sandimmune (non‑modified). Products are not interchangeable on a milligram‑to‑milligram basis.

Combination Therapy

• Transplant: commonly combined with mycophenolate mofetil and corticosteroids (triple therapy). Doses are individualized to balance rejection risk and toxicity.
• With azathioprine: used in certain regimens; monitor for additive myelosuppression or hepatotoxicity.
• Antihypertensives: calcium channel blockers are often chosen; some can raise cyclosporine levels. Monitor and adjust.
• Lipid‑lowering agents: use statins with caution; some combinations increase myopathy risk. Dose caps may apply.
• Antimicrobials: azoles and macrolides can raise cyclosporine levels; rifampin can lower them. Trough monitoring guides adjustments.

Patient Suitability and Cost‑Saving Tips

Cyclosporine may be considered for adult patients after solid‑organ transplant and for severe, recalcitrant plaque psoriasis or rheumatoid arthritis when other options fail or are not tolerated. Suitability depends on baseline kidney function, blood pressure, infection risk, malignancy history, and potential drug interactions. Pediatric use and other indications require specialist oversight.

Not ideal for patients with uncontrolled hypertension, significant kidney impairment not due to transplant, active serious infection, or a history of certain malignancies unless a specialist directs therapy. Routine monitoring should include serum creatinine, cyclosporine trough levels, blood pressure, lipids, electrolytes (potassium, magnesium), and liver enzymes. Avoid live vaccines during treatment.

Cost‑saving tips:

• Choose generic cyclosporine when appropriate; quality generics are widely available.
• Order a multi‑month supply when the prescription allows to reduce per‑shipment costs.
• Keep the product consistent (modified vs non‑modified) to avoid new monitoring after switches.
• Set calendar reminders for reorders so therapy is not interrupted.
• Discuss the intended target trough range with the care team; stable dosing can reduce unexpected monitoring visits.

Authoritative Sources

FDA Prescribing Information: Sandimmune (cyclosporine) non‑modified

FDA Prescribing Information: Neoral/Gengraf (cyclosporine) modified

Health Canada Drug Product Database: cyclosporine

Order Cyclosporine from CanadianInsulin: add to cart, upload your prescription, and we ship with prompt, express, cold‑chain handling.

This material is educational and does not replace the advice of a qualified healthcare professional. Always follow the guidance of the prescribing clinician and the product monograph.