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Common questions patients with myasthenia gravis ask about cyclosporine. What is cyclosporine?
Cyclosporine is an immunosuppressive medication that is sometimes prescribed for individuals with autoimmune myasthenia gravis (MG). It is manufactured as a capsule or an oral solution. You can purchase cyclosporine in generic form or by the brand names Gengraf®, Neoral®, Sandimmune®, or SangCya®.
How does cyclosporine work?
Myasthenia Gravis
of America, Inc.
and fatigable muscle weakness of MG.
How soon should I
see a response?
Drugs that may cause kidney damage
when combined with cyclosporine
Antibiotics – gentamicin, tobramycin, • Antifungals – amphotericin B How is cyclosporine taken?
be used solely for educational purposes. patient needs, and should not be used as Cyclosporine must be taken exactly as • Antivirals – acyclovir (Zovirax®) • Antiulcer – cimetidine (Tagamet®), condition. Instead, such decisions should or health care professional who is directly checking with your doctor. It is taken in familiar with the patient. The information contained in this publication reflects the • Nonsteroidals (NSAIDS) – ibuprofen views of the authors, but not necessarily those of the Myasthenia Gravis Foundation (Advil®, Motrin®, Nuprin®), diclofenac not constitute an endorsement. MGFA, its agents, employees, Directors, Chapters, its milk or fruit juices, but not grapefruit Medical/Scientific Advisory Board, and its Mix the liquid form in a glass container information contained in this publication. They specifically disclaim any warranty of merchantability, fitness for any particular • Cardiac/Blood Pressure – captopril information contained herein, and assume no responsibility for any damage or liability resulting from the use of such information.
Drugs that may raise blood
cyclosporine levels
interact with many other medicines, Striving for a world without MG.
Common questions patients with myasthenia gravis ask about cyclosporine.Antifungals – ketoconazole (Nizoral®), difluconazole (Diflucan®), • Any recent infections or immunizations.
Stomach/Ulcer – metoclopramide • Cardiac/Blood Pressure – diltiazem (Cardiazem®, What are some special considerations
when taking cyclosporine?
Hormones – danazol (Danocrine®), oral The physician wil check blood tests regularly contraceptives, methylprednisolone (Medrol®) to monitor for significant changes. BUN and serum creatinine are checked before beginning • Miscellaneous – bromocriptine (Parlodel®) cyclosporine, than once a month for 3 months, Drugs that may decrease cyclosporine levels
and then every 3 months. Cyclosporine blood levels are performed one month after starting, • Antibiotics – rifampin (Rifadin®, Rifamatev), periodically thereafter, especially after a change in dose. Blood levels are drawn 12 hours after the last dose, preferably before the morning dose.
Cyclosporine may cause unwanted side effects, • Anticonvulsants – phenytoin (Dilantin®), some of which may be serious. Others may Phenobarbital, carbamazepine (Tegretol®) go away as your body adjusts to the drug. It is Drugs that may accumulate in the blood
important to notify your health care providers when taken with cyclosporine
about side effects. Al ergic reactions can be life threatening and you should get emergency help at • Steroids – prednisolone (Medrol®) once. These include hives, severe itching, tightness • Cardiac – digoxin (Lanoxin®) in the neck or chest, trouble breathing, or swel ing Other reactions that may occur
of the lips, tongue or throat. Also serious, are fever, chil s, blood in the urine, and seizures. Careful • Cholesterol – lovastatin (Mevacor®) dental hygiene is important because cyclosporine may cause gum swelling or bleeding. Other, more • Cardiac/Blood Pressure – ACE inhibitors common side effects may include acne, increased (Accupril®, Altace®, Capoten®, Lotensin®, hair growth, headache, nausea and vomiting.
Monopril®, Prinivil®, Vasotec®, Zestril®) may What will my doctor want to know
before prescribing cyclosporine?
Since cyclosporine is a strong medicine, the
doctor and patient must consider its risks and benefits. Your doctor will ask you about:• Current medications and treatments.
• History of any allergies.
• History of high blood pressure.
• History of liver or kidney disease.


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