Maybe you've recently had an organ transplant, like a kidney. Or maybe you're suffering from a joint disease like rheumatoid arthritis or a skin condition like psoriasis. In a situation like this, your doctor may have told you to use a medication called Cyclosporine. This is a medication that needs to be used with some care and exactly as directed. So today, let's talk about it, in simple language that you can understand, as if you were talking to a close friend.
What really happens with this medicine?
Simply put, cyclosporine is a drug that suppresses your body's immune system . Now you might be thinking, "Wow, is suppressing your immune system a good thing?" Sometimes, yes.
Imagine, when you get a new organ transplant, your body's immune system sees the new organ as "foreign" and starts attacking it. This is what we call organ rejection. So what cyclosporine does is slow down that immune system a little bit and helps the body accept the new organ.
Similarly, in diseases like rheumatoid arthritis and psoriasis, our own immune system mistakenly attacks healthy parts of our own body (joints, skin). Cyclosporine controls this overactive immune system and reduces symptoms.
Things you need to tell your doctor before starting medication
Before starting this medication, it is very important that your doctor knows your complete health history. If you have any of the conditions listed below, be sure to tell your doctor.
| Do you have these conditions? | Things to pay special attention to |
|---|---|
| Cancer | If you currently or have previously had cancer. |
| High Blood Pressure | Report uncontrolled high blood pressure. |
| Kidney or Liver Disease | Any problems with kidney or liver function. |
| Infection | Any current infection (fever, cough, etc.). |
| Previous treatment | If you have previously received radiation therapy or ultraviolet light treatment for skin diseases or cancer. |
| Allergies | If you are allergic to cyclosporine, castor oil, other medicines, foods or preservatives. |
| Pregnancy or breastfeeding | If you are pregnant, trying to get pregnant, or breastfeeding. |
How exactly do I use this medicine?
This is the most important part. You must follow these instructions exactly to get the most out of the medicine and minimize side effects.
- Accurate measurement: Since this medicine comes as an oral solution, you will receive a specially marked spoon or cup to measure it. Do not use teaspoons or tablespoons that you have at home. They will not give you an accurate measurement.
- Dissolving the medicine: Add the prescribed amount of medicine to a glass of room temperature orange juice or apple juice, stir well, and drink.
- Very important: Never take this medicine with grapefruit juice. Grapefruit juice can change the way this medicine works in the body. This can be dangerous. Ask your doctor before mixing it with any other liquid.
- Regular time: Make it a habit to take your medicine at the same time every day. Do not stop taking your medicine or change the dosage without your doctor's advice.
If you are giving this medicine to children, although it is prescribed for some conditions in children over the age of 1, you should discuss it with your pediatrician. If someone over the age of 65 is taking this medicine, a lower dose may be needed as the body may be more sensitive.
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Do not take a double dose for any reason. If you often miss a dose, tell your doctor.
What if I take too much medicine?
If you think you have taken too much medicine, do not panic and immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Department (ETU) of the nearest hospital.
Things not to use with this medicine
This is very important: Cyclosporine can interact with other medications, including herbal products. Therefore, it is important to tell your doctor about all the medications you are taking (prescribed by other doctors, over-the-counter medications, vitamins, and herbal products).
It is strongly advised not to use cyclosporine with the following conditions.
- Grapefruit juice
- St. John's wort (herbal product)
- Tacrolimus (a similar drug)
- Some specific medications such as Bosentan, Cidofovir, Cisapride, Ranolazine.
In addition, many other medications can interact with this. For example:
- Some antibiotics
- Antifungals
- Some blood pressure medications
- Some cholesterol-lowering medications (statins)
- Pain and inflammation medications (NSAIDs) - e.g. Ibuprofen, Naproxen
- Birth control pills
- Some medications for seizures
This list is not complete, so tell your doctor about everything you take.
Things to keep in mind when taking medication
- Regular check-ups: Your doctor will ask you to see him regularly to monitor your condition. He will also order regular blood tests to check your kidney function and medication levels. Don't skip these.
- Protection from infections: Since this medicine lowers your immunity, you may get infections easily. If you develop a fever, cold, or sore throat, do not self-medicate and tell your doctor immediately.
- Sun protection: This medication may make your skin very sensitive to sunlight. So be careful in the sun. Wear long-sleeved clothing and use a good sunscreen.
- Gum health: Some people may experience swollen or bleeding gums from this medication. So brush your teeth well, floss, and see a dentist regularly.
- Alcohol: Avoid drinking alcohol. It can interfere with the effectiveness of this medication.
- Changes in consciousness: Some people may feel sleepy or dizzy. Do not drive or operate machinery until you know exactly how this medicine affects you.
Possible side effects
Like any medication, cyclosporine can cause side effects. Some are serious, while others are mild.
| Type of side effect | Symptoms |
|---|---|
| If you experience these symptoms, tell your doctor immediately. | |
| Allergic Reaction | Skin rash, itching, swelling of the face, lips or tongue. |
| Nervous system problems | Numbness in the limbs, seizures, changes in vision. |
| Blood pressure and others | High blood pressure, severe stomach pain, vomiting. |
| Liver problems | Yellowing of the eyes or skin (jaundice). |
| If these persist or become bothersome, tell your doctor. | |
| Common disorders | Swollen/bleeding gums, nausea, diarrhea, unwanted hair growth on the body or face, tremors. |
Take-Home Message
- Cyclosporine is a medication that should be used very carefully, only under the advice of your doctor.
- Never take this medicine with grapefruit juice. Only take it with orange or apple juice.
- It is imperative to inform your doctor about all other medications, vitamins, and herbal products you are taking.
- Be sure to attend the blood tests and clinics prescribed by your doctor.
- If you notice a serious side effect (such as facial swelling, seizures), seek medical advice immediately.
- This medicine is for you only. Never share it with others.
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