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CYCLOSPORINE: It is a cyclic polypeptide containing 11 amino acid it suppresses humeral immunity and to a great extent, cell-mediated reactions. This action is due to a specific and reversible inhibition of immunocompetent lymphocytes in the G0 or G1 phases of cell cycle T-helper cells are the main target but T-suppressor cells are also suppressed. Cyclosporine also inhibits lympholine production and release.

Indications: Orally used for prevention of graft rejection after kidney, liver heart lungs pancreases By IV infusion used in bone marrow transplant.

Dosage: Oral first dose given 4-12 hrs. before the transplantation 10-15mg/kg. This dose in continued daily for 1-2 weeks after which a maintenance dose of 2-6 mg/kg/day is continued. IV infusion: Strating dose one day before the transplantation 3-5 mg/kg/day continue for 2 weeks after transplant. Then oral maintenance dose of 12.5 mg/kg/day in 3 divided doses for 6 months to a year.

Contra Indications: Hypersensitivity, lactation.

Special Precautions: Dose should be carefully titrated Renal and/or hepatic impairment, possibility of hyperkalaemia hypertension, vaccinations are less effective.

Pediatrics: Use with caution
Pregnancy: Safety has not been established
Lactation: Safety has not been established
Elderly: Reduced dose my be necessary

Side effects: Kidney damage, convulsions, hypertension liver damage tremor hirsutims gingival hypertrophy typerkalaemia fluid retention increased susceptibility to infections GI symptoms.

Drug Interactions: Additive nephrotoxicity due ot aminoglycosides amphotericin B ciprotoxacin colchincen melphalan co-trimoxazole NSAIDs. Cyclosporine blood levels increased iby ditiazern, doxycycline erthormycin ketoconazole methyl prednisolone nicardipine verapamil oral contraceptives carbamzepine isoniazid phenobarbitone phenytoin ifampicin reduce cyclosprine levels.