What does it do?

Ciclosporin is an immunosuppressant medicine used to treat some types of arthritis, kidney and skin problems. It is also sometimes used for other conditions.

Before you start

• Tell your doctor if you have liver, kidney or blood pressure problems, diabetes or gout; or if you have taken immunosuppressant medicines in the past.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.
• 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.

How should you take it?

Take ciclosporin regularly as directed.
Measure the liquid carefully with the syringe supplied and add to a glass of apple or orange juice (do not use grapefruit juice or paper/polystyrene cups). Stir well and drink straight away. To make sure you get the full dose, add some more juice to the glass and drink that too.
Wipe the outside of the syringe with a dry tissue after use – do not rinse. Do not refrigerate ciclosporin liquid.

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. echinacea, St John's wort) 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 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:

• 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.
• You will need regular blood tests to measure the amount of ciclosporin in your blood.
• Grapefruit, grapefruit juice or sour/Seville oranges may react with ciclosporin. Discuss with your pharmacist.