Neoral (cyclosporine) is a commonly-used immunosuppressant in both medical and veterinary fields. Uses range from treating symptoms of chronic overactive immune disorders to preventing organ rejection in transplants. The medication is also showing promise in a number of experimental studies on conditions ranging from asthma to healing traumatic brain injury.

While immunosuppression is beneficial at times, it also carries risk of serious, even potentially fatal, complications. This medication should never be taken to treat a self-diagnosed illness, and patients should be carefully monitored for the duration of treatment.

Treating Overactive Immune System Disorders

There are quite a few conditions believed to the result of an overactive immune system, often described as the body attacking itself. Why it happens is poorly understood, but it often produces symptoms ranging from unsightly to debilitating, and sometimes fatal.

Suppressing the immune system with a medication like Neoral does not cure the problem, but very often minimizes or eliminates symptoms in conditions such as:

• Psoriasis
• Rheumatoid arthritis
• Pyoderma gangrenosum
• Atopic dermatitis (eczema)
• Autoimmune urticaria (hives)
• Keratoconjunctivitis sicca (dry eye syndrome)
• Ulcerative colitis (inflammatory bowel disease)

Since symptoms of these disorders usually appear only occasionally, and risk of serious side effects increases with length of treatment, Neoral is usually given only as-needed during a flare-up rather than taken long-term as a preventative measure. Neoral should be taken twice daily at 12 hour intervals:

• Psoriasis - 2.5 to 5 mg daily
• Rheumatoid Arthritis - 1.5 to 5 mg daily
• Pyoderma gangrenosum - 2 to 3 mg daily
• Atopic Dermatitis - 2.5 to 5 mg daily
• Autoimmune urticaria - 1 to 3 mg daily
• Keratoconjunctivitis sicca - 2 drops daily
• Ulcerative colitis - 1 to 4 mg daily

It is not unusual for dosage strength to be adjusted during treatment, or for additional medications to be given to further ease symptoms. Follow doctor instructions as closely as possible for maximum effectiveness.

Preventing Organ Rejection

If Neoral is given to prevent organ rejection, treatment will begin shortly prior to surgery in the hospital, and will usually continue intravenously until patient release. Once home, treatment typically continues either with tablets or an oral solution:

• 10 to 15 mg daily, split into two doses
• Take each dose as close to 12 hours apart as possible
• Take a missed dose as soon as remembered

In the case of organ transplants treatment typically lasts several months, sometimes up to a year. Because the risk of side effects is significantly increased during longer treatment durations, close monitoring is strongly recommended.

Warnings for Patients Taking Neoral

There are a number of considerations to be aware of while taking an immunosuppressant, for both patients and health-care providers:

• Notify all physicians, dentists, and other practitioners of Neoral use before undergoing any procedures or taking any medications.
• Dental check-ups should be performed every three months during treatment to ensure no infections are present.
• Blood tests should be administered every two weeks to monitor health and ensure the medication is working properly.
• Strictly avoid any other medications, including vaccinations, supplements and non-prescription drugs, without explicit doctor or pharmacist approval.
• Try to avoid exposure to anything contagious; even a common cold can result in serious complications while taking an immunosuppressant.
• Monitor any wounds closely for signs of infection.
• Seek medical attention quickly if illness or infection does occur.
• Avoid grapefruit and grapefruit juice; it may make the medication less effective.

Most side effects with short-term Neoral use are mild; long-term use may cause more serious issues, such as poor blood clotting. The most serious concern with any length of treatment is exposure to illness or infection that the body is unable to fight off while the immune system is suppressed. Communication with a healthcare provider and regular checkups are important for maintaining health and good treatment outcomes.