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Indications

Sandimmune oral solution is used to prevent organ transplant rejection.

Cyclosporine is an immunosuppressant that weakens your immune system to stop it from attacking the new organ you receive. Sandimmune oral solution helps your new organ function normally after receiving a liver, kidney, or heart transplant.

Dosage and Administration

The dose of Sandimmune oral solution that is prescribed will vary depending on the individual being treated. Follow all instructions from your healthcare provider and read packaging labels carefully to ensure the best response from treatment. Do not take more or less than prescribed for longer than recommended.

• Take with or without food, but stay consistent with the way you take your doses
• Take your doses at the same times each day
• Patients usually take Sandimmune oral solution
• Measure your Sandimmune oral solution dose using the provided medicine syringe
• Mix the dose with room temperature apple or orange juice; do not switch the juices you use often
• Do not mix Sandimmune oral solution with milk
• Drink the whole mixture right away
• After drinking, rinse the glass with more juice and drink
• Continue taking Sandimmune oral solution as prescribed
• Store at room temperature away from children and pets
• Do not let the oral solution freeze

Side Effects

Sandimmune oral solution may cause some side effects while suppressing your immune system to prevent organ transplant rejection. Speak to your healthcare provider for more information regarding any symptoms that you might encounter.

Common Sandimmune oral solution side effects:

• Headache
• Stomach pain or diarrhea
• Upset stomach, nausea, vomiting
• Hair growth
• Acne
• Dizziness
• Flushing
• Signs of a common cold
• Joint pain
• Leg cramps

Serious Side Effects

More serious adverse effects may develop during treatment with Sandimmune oral solution. Contact your healthcare provider if you experience any of the following symptoms:

• High blood pressure (bad headache, dizziness, fainting, changes in eyesight)
• Kidney problems (inability to pass urine, change in amount of urine passed, blood in your urine, weight gain)
• Electrolyte problems (mood changes, confusion, muscle pain or weakness, abnormal heartbeat, seizures, decreased hunger, upset stomach, vomiting)
• Unexplained bruising or bleeding
• Feeling very tired or weak
• Burning, numbness, or tingling sensation
• Chest pain or pressure, fast heartbeat
• Gum changes
• Hearing loss
• Shortness of breath
• Shakiness
• Swelling
• Liver problems (dark urine, tiredness, decreased appetite, upset stomach, stomach pain, light-coloured stools, vomiting, jaundice)
• Signs of a brain problem called progressive multifocal leukoencephalopathy (confusion, memory problems, low mood, change in behaviour, change in strength on one side, trouble speaking or thinking, changes in balance, changes in eyesight)

Allergic Reactions

Do not take Sandimmune oral solution if you are allergic to cyclosporine or any of the other solution ingredients. Contact your healthcare provider right away if you experience any of the following signs of an allergic reaction:

• Rash, hives
• Swollen, blistered, peeling skin
• Tightness in your chest or throat
• Swelling face, lips, tongue, or throat

Cautions

• Before taking Sandimmune oral solution, tell your healthcare provider if you have any of the following conditions:
  • Cancer
  • Kidney problems
  • Liver disease
  • High blood pressure
  • Skin lesions of unknown origin
  • Radiation treatment
  • Mineral imbalance
  • Recent or current infections
  • High cholesterol or triglyceride levels
• Consult your healthcare provider before taking Sandimmune oral solution if you are pregnant or breastfeeding.
• Sandimmune oral solution weakens your immune system which increases your risk of getting an infection. Wash your hands often and avoid people with infections, colds, or flus.
• Discuss risks with your healthcare provider before taking Sandimmune oral solution because some users have developed lymphoma and other cancers. Your risk may increase if taken with other medicines that affect your immune system.
• Some drugs may interact with Sandimmune oral solution and cause adverse reactions. Tell your healthcare provider about all the medications that you take, including over the counter medicines, but especially any of the following:
  • Coal tar
  • Orlistat
  • Medications that weaken your immune system like natalizumab, rituximab, or tofacitinib
  • Potassium supplements
  • Diuretic medicines like amiloride or spironolactone
  • Tacrolimus
  • Bosentan
  • Mifepristone
  • St. John’s wort
  • Aliskiren
  • Dabigatran
  • Dronedarone
  • Elagolix
  • Statins like pitavastatin or simvastatin
  • Voxilaprevir
• Avoid extended exposure to the sun, sunlamps, and tanning beds during treatment with Sandimmune oral solution because your risk of skin cancer may be raised.
• Consult with your healthcare provider before receiving any vaccines while taking Sandimmune because these may increase your risk of infection or may cause the vaccine to not work as well.
• Avoid ingesting grapefruit during treatment with Sandimmune oral solution because it may cause an increase in side effects.
• Avoid alcohol during treatment because it can cause an increase in side effects, especially dizziness.

Form and Strength

This organ transplant rejection medicine is available in oral solution form.

• Sandimmune oral solution strength:
  • 100 mg/ml

The 100 mg/ml strength Sandimmune oral solution is available in volumes of 50 ml.

FAQ

What should not be taken with Sandimmune?

During treatment with Sandimmune oral solution, you should avoid ingesting grapefruit products because this can cause an increase in side effects. Also avoid drinking large amounts of alcohol because it can cause an increase in dizziness, especially since the oral solution contains alcohol.

Can you go in the sun with cyclosporine?

You can go outside in the sun while taking Sandimmune oral solution but ensure that you wear sunscreen and protective clothing. Avoid prolonged exposure to the sun as well as sunlamps and tanning beds, because the medication may increase your risk of developing skin cancer.

Resources:

1. https://www.novartis.com/us-en/sites/novartis_us/files/sandimmune.pdf
2. https://www.drugs.com/cdi/sandimmune-cyclosporine-injection.html
3. https://www.healthlinkbc.ca/medications/cyclosporine-microemulsion-solution-oral