What does it do?

Ciclosporin is an immunosuppressant used with other medicines to prevent transplant rejection.

Before you start

• Ciclosporin weakens your immune system, making it harder for your body to fight infections. You may need tests before you start to make sure you don't have any infections like tuberculosis (TB), HIV, or hepatitis B and C.
• Ask your doctor what vaccines you might need before you start and while you are taking ciclosporin. You should not have a live vaccine while taking ciclosporin.
• If you plan to become pregnant, or find you are pregnant, discuss this with your doctor. Tell your doctor if you are breastfeeding.

How should you take it?

Take ciclosporin regularly as directed with a glass of water. Swallow the capsules whole.
Keep the capsules in the foil strips at all times – only remove them to take a dose.

What if you forget a dose?

Take the missed dose as soon as possible. If it is close to the time for your next dose, skip the missed dose and carry on as normal. Do not take two doses at the same time.

Can you take other medicines?

Some medicines available without a prescription may react with ciclosporin including:

• anti-inflammatories, such as diclofenac (e.g. Voltaren®), ibuprofen (e.g. Nurofen®), or aspirin (e.g. Disprin®, in doses used for pain relief). These can also be found in some cold and flu medicines (e.g. Nurofen Cold and Flu®).
• levonorgestrel emergency contraceptive pill (e.g. Postinor-1®)
• orlistat (Xenical®)

Tell your pharmacist or doctor about all medicines or treatments that you may be taking, including vitamins, herbal products (e.g. St John's wort, echinacea) or recreational drugs.

What side effects might you notice?

Side Effects	Recommended action
Reduced number of blood cells that fight infections or help your blood to clot - symptoms include: fever, chills, sore throat or generally feeling unwell, or easy or unusual bruising or bleeding Seizures Symptoms of liver problems including: yellow skin or eyes, itching, dark urine, pale bowel motions, abdominal pain	Tell your doctor immediately
Changes in vision, confusion Enlarged, tender or bleeding gums Increased blood pressure Joint, muscle or bone aches and pains, tremor, tingling or numbness Peeing more often, feeling thirsty	Tell your doctor
More body and facial hair, acne or oily skin Swollen feet or legs Headache Nausea, vomiting, diarrhoea, stomach pain	Tell your doctor if troublesome

If you notice any other effects, discuss them with your doctor or pharmacist.

Other information:

• Do not stop taking ciclosporin unless your doctor at the transplant clinic tells you to. You may have to take ciclosporin for the rest of your life.
• You will need regular blood tests to measure the amount of ciclosporin in your blood. On the morning of the blood test, do not take your regular dose of ciclosporin until after the blood has been taken. Other blood tests will monitor how your kidneys are working and your cholesterol levels (ciclosporin can increase cholesterol).
• Protect yourself from too much sunlight while taking immunosuppressant medicines (they may increase your risk of skin cancer). Always cover up and apply a thick layer of broad spectrum sunscreen (at least SPF30) when outside. Do not use sunbeds.
• Women using ciclosporin for a long time may need cervical screening more often. Discuss with your doctor.
• It is important to tell anyone who gives you medical or dental treatment that you are taking ciclosporin.
• Grapefruit, grapefruit juice or sour/Seville oranges may react with ciclosporin. Discuss with your pharmacist.