SANDIMMUN NEORAL 50ML SYP

Cyclosporin, the active ingredient in Cyclosporin Syrup/Suspension, primarily exerts its immunosuppressive effects by inhibiting T-lymphocyte activation. It selectively binds to cyclophilin, a cytosolic protein within T-lymphocytes, forming a cyclosporin-cyclophilin complex. This complex then blocks the calcium-dependent phosphatase pathway in the cytoplasm of T-cells by inhibiting the enzyme calcineurin. Normally, calcineurin activates the transcription of interleukin-2 (IL-2) and other cytokines required for T-cell proliferation and maturation. By inhibiting calcineurin, cyclosporin prevents the transcription of these essential cytokines, leading to a decrease in T-cell activation, proliferation, and subsequent immune response. This mechanism of action is particularly useful in preventing organ rejection in transplant patients and managing certain immune-mediated disorders.

Cyclosporin

Immunosuppressant

Suspension

The following are the uses of Cyclosporin Syrup/Suspension:

• Used for preventing organ rejection in transplant patients.
• Used for managing severe rheumatoid arthritis.
• Used in treating severe psoriasis and atopic dermatitis.
• Used to prevent graft-versus-host disease in bone marrow transplants.
• Effective for treating nephrotic syndrome in children.
• Helps manage Crohn's disease and ulcerative colitis.
• Can be used for certain eye conditions like dry eye disease.

In the case of an overdose of Cyclosporin Syrup/Suspension, it is important to seek medical advice promptly. Symptoms may include tremors, nausea, vomiting, and in severe cases, seizures or kidney damage. Prompt action should be taken, including contacting a healthcare professional or a poison control center for guidance on managing the overdose. Quick response and appropriate medical care are vital to ensure the best possible outcome.

In the case of a missed dose of Cyclosporin Syrup/Suspension, it is important to take the missed dose as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of side effects. If you miss multiple doses, contact your healthcare provider for guidance on how to adjust your dosing schedule and ensure the medication remains effective.

To administer Cyclosporin Syrup/Suspension, shake the bottle vigorously, measure the prescribed dose with an accurate measuring device like a syringe, and administer it orally, following the dosing instructions provided by your healthcare professional, typically taken twice a day, 12 hours apart, regardless of meals.

Here are the conditions or situations when Cyclosporin Syrup/Suspension should not be used:

• Allergy Should not be used if the patient has a known allergy or hypersensitivity to Cyclosporin or any of the excipients in the syrup/suspension.
• Severe liver disease Contraindicated in patients with severe liver impairment or liver disease as it can lead to increased toxicity.
• Uncontrolled high blood pressure Not recommended for individuals with uncontrolled hypertension (high blood pressure).
• Kidney impairment Cyclosporin should be used with caution in patients with kidney impairment and may not be suitable for those with severe kidney disease.
• Uncontrolled infections Should not be administered to patients with uncontrolled systemic infections.
• Malignancies Contraindicated in patients with certain types of cancers or malignancies.
• Pregnancy and breastfeeding Not recommended during pregnancy and breastfeeding unless the potential benefits outweigh the risks.
• Immunodeficiency Cyclosporin is not indicated for patients with certain immunodeficiency disorders.
• Certain skin conditions Should be avoided in patients with untreated psoriasis or other skin conditions.

The side effects of Cyclosporin Syrup/Suspension may include:

• Nausea and vomiting
• Tremors or shaking
• High blood pressure
• Headache
• Kidney problems
• Liver dysfunction
• Increased hair growth
• Gum swelling

Following are the precautions and warnings for Cyclosporin Syrup/Suspension:

• Cyclosporin should be used with caution in patients with impaired kidney or liver function, as dosage adjustments may be necessary.
• Regular monitoring of kidney function and blood pressure is essential during treatment.
• Avoid using Cyclosporin if you have a known allergy to any of its ingredients, including cyclosporine or any other components of the syrup/suspension.
• This medication may increase the risk of infection due to its immunosuppressive effects. Patients should be cautious and report any signs of infection to their doctor immediately.
• Cyclosporin can cause high blood pressure, so regular monitoring is required, and lifestyle changes may be recommended to manage it.
• Patients with a history of cancer or skin disorders should inform their doctor, as Cyclosporin may increase the risk of certain types of cancers and skin issues.
• Avoid consuming grapefruit or grapefruit juice while taking Cyclosporin, as it can affect the medication's metabolism.
• Cyclosporin may cause photosensitivity, so limit sun exposure and use protective measures when outdoors.

Following are the drug interactions for Cyclosporin Syrup/Suspension:

• Concomitant use with other immunosuppressants like tacrolimus or sirolimus can increase the risk of infection and nephrotoxicity due to additive effects.
• Cyclosporin may interact with certain antibiotics (e.g., erythromycin, clarithromycin) and antifungal medications (e.g., ketoconazole, fluconazole), leading to increased cyclosporin levels and potential toxicity.
• It can decrease the effectiveness of oral contraceptives, requiring additional contraceptive measures.
• Grapefruit juice and certain herbal supplements (e.g., St. John's Wort) may affect cyclosporin metabolism and increase its levels in the body.
• The effect of Cyclosporin may be reduced by antacids containing magnesium or aluminum, as they can decrease its absorption.
• Caution is advised with nonsteroidal anti-inflammatory drugs (NSAIDs) as they may increase cyclosporin toxicity and affect kidney function.
• Certain anti-seizure medications (e.g., phenytoin, carbamazepine) can decrease Cyclosporin levels, potentially reducing its therapeutic effect.

Following are the food interactions for Cyclosporin Syrup/Suspension:

• Grapefruit consumption should be avoided as it can increase Cyclosporin levels in the blood, leading to potential toxicity.
• Alcohol intake is not recommended as it may affect the metabolism of Cyclosporin, increasing the risk of side effects.
• Avoid high-fat meals as they can decrease the absorption of Cyclosporin, reducing its effectiveness.
• Cranberry juice and its extracts may decrease Cyclosporin's bioavailability, so it's best to consume them cautiously.
• Limit potassium-rich foods like bananas, oranges, and tomatoes, as Cyclosporin can increase potassium levels.
• Avoid natural licorice, which may increase potassium levels and interact with Cyclosporin's effects.
• Consult a healthcare provider about consuming milk and dairy products, as they may affect Cyclosporin absorption.

Cyclosporin Syrup/Suspension requires careful storage and disposal to maintain its effectiveness and ensure safety. Store the medication at room temperature, in a cool and dry place, away from direct sunlight and heat sources like ovens or radiators, as temperature fluctuations can impact its quality. Keep the syrup in its original container, tightly sealed to prevent contamination. Pay attention to the expiration date, and never use the medication after it has expired. When disposing of Cyclosporin Syrup/Suspension, do not flush it or pour it down the drain. Instead, consult a pharmacist or healthcare professional for appropriate disposal methods to prevent environmental contamination. Lastly, always keep medicines out of children's reach to avoid accidental consumption.

Following are the quick tips for Cyclosporin Syrup/Suspension:

• Ensure you follow the prescription instructions provided by your healthcare professional for effective treatment.
• Before each use, shake the bottle vigorously to maintain a well-mixed suspension.
• Administer the syrup with a glass of water to enhance absorption and avoid beverages like tea, coffee, or dairy products.
• Maintain a consistent routine by taking your dose at the same time daily to optimize treatment and memory.
• If stomach discomfort occurs, consider taking the syrup with food or after meals for relief.
• Store the syrup in a secure location, out of children's reach, to prevent accidental consumption.
• Regularly monitor your progress and consult your doctor if you have any concerns or experience unusual symptoms.