What is Cyclosporine: Uses, Warnings & Interactions

Take cyclosporine doses as directed. Oral cyclosporine doses may change over the first few weeks of treatment.

Read the cyclosporine instruction sheet or information sheet provided by the prescriber or the clinic.

Cyclosporine nonmodified and cyclosporine modified are not interchangeable. Use only the type of cyclosporine that has been prescribed. 

How to take cyclosporine capsules:

• Take doses at the same time every day.

• Take doses with or without food, but take them the same way every day.

• Do not take cyclosporine capsules with grapefruit juice.

• Swallow capsules whole with a drink of water. Do not chew.

• Store cyclosporine capsules at room temperature.

• Do not store cyclosporine capsules in a refrigerator. 

• If the capsules get cold, sediment or flakes may form inside the capsule. These will go away when the capsules warm to room temperature. 

• Once the bottle is opened, the capsules are only good for two months.

How to take cyclosporine oral solution:

• Take doses at the same time every day.

• Take doses with or without food, but take them the same way every day.

• Always measure doses with the calibrated oral syringe supplied with the medicine.

• The dose can be mixed with apple juice or orange juice and warmed to room temperature to make it more palatable. Do not mix it with grapefruit juice or milk. Stir the mixture well and immediately drink it. Rinse the container with water and drink it, as well. 

• Dry the measuring device when done. Do not clean it with water.

• Replace the child-proof cap. Some bottles may require that you remove the bottle adapter before resealing the bottle with the cap. The bottle adapter can be dried with a towel. Do not get it wet or wash it with water.

• If the measuring device or bottle adapter is cleaned with water or immersed in water, allow it to dry completely before using it again.

• Store cyclosporine oral solution at room temperature.

• Do not store cyclosporine oral solution in a refrigerator. 

• Throw out the solution two months after the bottle has been opened.

How to administer cyclosporine eye drops:

• Read any Patient Information sheet included with this medicine.

• Doses are taken twice daily, 12 hours apart.

• Cyclosporine eye drops come in single-use vials or multidose bottles.

• Wash your hands with soap and water.

• Remove any contact lenses.

• Do not allow the vial tip or the multidose bottle tip to touch the eye or any other surface, including your fingers or skin.

• Turn the single-use package or the multidose bottle upside down a few times to mix the medicine before you use it.

• Use the single-use vial right away if you open the package.

• Remove the protective cap from the multidose bottle if that’s what you’re using.

• Lie down or tilt your head back.

• With your index finger, pull down the lower lid of your eye to form a pocket.

• Hold the vial or dropper close to your eye with the other hand.

• Drop a single drop of Restasis into the pocket made between the lower lid and eyeball. 

• Gently close your eyes.

• Place your index finger over the inner corner of your eye for one minute.

• Do not rinse or wipe the dropper or allow it to touch anything, including your eye.

• Discard each single-use vial after using it, even if there is solution remaining.

• If using the multidose bottle, immediately replace the protective cap without touching the bottle tip.

• Wait at least 15 minutes before you use other eye drops (including artificial tears) or replace your contact lenses.

• Store the medicine in a closed container at room temperature.

How to administer Verkazia cyclosporine eye drops:

• Read any Instructions for Use sheet included with this medicine.

• Doses are taken four times daily: morning, noon, afternoon, and evening.

• If any other eye drops or ointments are used, they must be taken 10 minutes before or 10 minutes after the Verkazia dose.

• Caregivers should administer doses to children.

• Verkazia eye drops come in single-use vials.

• Administer the drops following the same instructions for administering eye drops above.

• Immediately throw away the single-use vial after use, even if there is still medicine remaining.

• Store this medicine at room temperature. Do not freeze.

• Keep vials in their pouch.

Ask the prescriber what to do if a dose of oral cyclosporine is missed.

• The clinic or prescriber will usually give you an information or instruction sheet about this drug. It should tell you what to do when a dose is missed.

• Most doctors or clinics will instruct patients to take a missed dose.

• They may have specific rules or timelines about when a missed dose should be skipped. Follow these instructions faithfully.

A missed dose of cyclosporine eye drops should be taken as soon as remembered.

• If it’s almost time for the next dose, skip the missed dose and take the next dose as scheduled.

Do not take a missed dose of Verkazia.

• Take the next dose as scheduled.

Do not take extra medicine to make up for a missed dose.

This medicine is not right for everyone. 

Do not use it if you have had an allergic reaction to cyclosporine or any of the inactive ingredients in the medication.

Tell any doctor or other healthcare provider who treats you that you are taking this medication, particularly before any radiation treatment or UV treatment.

The prescriber will require regular visits, blood tests, and other tests to monitor treatment and catch side effects before they become serious health issues. Keep all appointments.

Before taking oral cyclosporine, tell the prescriber if you are pregnant, breastfeeding, or if you have:

• Kidney disease

• Liver disease

• Cancer

• Anemia

• A bleeding disorder

• High blood pressure

• Eye or vision problems

• A history of seizures.

Oral cyclosporine can cause very serious adverse effects, particularly at high doses. These include: 

• Kidney damage (very common)

• Kidney dysfunction (very common)

• Liver damage

• Increased risk of infections, including rare and life-threatening infections

• Increased risk of cancer, including skin cancer or cancer of the lymphatic system (lymphoma)

• High blood pressure

• Nerve damage

• High potassium

• Low magnesium

This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.

This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.

Do not stop taking cyclosporine doses without talking to your doctor.

Oral cyclosporine should never be taken with:

• The cholesterol medications simvastatin and pitavastatin

• The muscle relaxant bosentan

• Addyi (flibanserin), cidofovir, cisapride, Multaq (dronedarone), Orilissa (elagolix), ranolazine, Zepatier (elbasvir-grazoprevir), Zokinvy  (lonafarnib)

When prescribed for psoriasis, cyclosporine should never be used with certain psoriasis treatments, including:

• Methotrexate

• Other immune suppressants

• UVB or PUVA therapy

• Radiation therapy

• Coal tar therapy

Cyclosporine has a long list of potentially hazardous drug interactions. To be safe, tell the prescriber about all prescription drugs, over-the-counter medications, and supplements you take or plan to use, particularly:

• Other immune suppressants

• Cancer drugs that suppress bone marrow

• Live vaccines

• Statins

• Aminoglycoside antibiotics

• The antibiotics clarithromycin, erythromycin, or metronidazole

• The fungal infection medications fluconazole, itraconazole, ketoconazole, posaconazole, or voriconazole

• Barbiturates

• Sleeping pills called orexin antagonists, such as Quvivq (daridorexant) or Dayvigo (lemborexant)

• Potassium supplements or potassium-containing drugs 

• Potassium-sparing diuretics 

• Migraine drugs called CGRP inhibitors

• Cystic fibrosis medications called CFTR modulators

• The supplement St. John’s wort (particularly in transplant patients)

• Colchicine, digoxin, ezetimibe, mifepristone, nefazodone, Paxlovid, tenofovir 

Avoid red wine, grapefruit juice, grapefruit, or red yeast rice supplements when taking oral cyclosporine.

Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.

Ask your doctor before you use the herbal supplement St. John’s wort. For transplants or grafts, the doctor may forbid its use entirely because of the risk of transplant rejection.

This medicine may interfere with vaccines. Ask the prescriber before you get a flu shot or any other vaccine.

There are no known drug interactions with cyclosporine eye drops.