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Cyclosporine is a medication that requires careful consideration due to its potential risks and side effects. It is essential to be aware of these risks and to follow your healthcare provider's instructions closely. Below is a comprehensive overview of safety precautions and warnings associated with the use of cyclosporine, particularly cyclosporine modified (Gengraf).

• Infection Risks: Cyclosporine suppresses the immune system, increasing the susceptibility to infections, which may become severe or life-threatening. Inform your healthcare provider if you experience symptoms such as persistent sore throat, fever, or unusual skin changes.

• Cancer Risks: Long-term use of cyclosporine is linked with an increased risk of cancer, including lymphoma and skin cancer. Discuss your cancer risk factors with your healthcare provider, especially if you have a history of cancer or have undergone treatments like phototherapy or radiation.

• Blood Pressure and Kidney Concerns: Cyclosporine can cause high blood pressure and kidney damage, risks that are heightened with higher doses and prolonged use. Regular monitoring of blood pressure and kidney function is crucial.

• Liver and Brain Effects: There is a risk of liver damage, and in some cases, brain damage, particularly when combined with high doses of steroids. Liver function should be regularly checked, and any neurological symptoms should be reported immediately.

• Hematological Effects: Although rare, cyclosporine may lead to low platelet and red blood cell counts, which can have serious implications, especially in transplant patients.

• Electrolyte Imbalance: High potassium and uric acid levels are possible. Symptoms like muscle weakness or heart irregularities should be promptly discussed with a healthcare professional.

• Alcohol Content: Cyclosporine (Gengraf) contains alcohol, posing risks for individuals with a history of liver issues, epilepsy, or alcohol use disorder. Pregnant or breastfeeding individuals should also be cautious due to potential harm from alcohol.

• Brand Consistency: Different brands of cyclosporine may vary in potency. Switching between brands without medical guidance can result in adverse effects due to changes in drug absorption.

• Contraindications: Do not use cyclosporine if you have an allergy to it. People with rheumatoid arthritis or plaque psoriasis should avoid it if they have kidney issues, uncontrolled high blood pressure, or cancer, and if they are undergoing certain treatments like phototherapy or taking other immunosuppressants.

In case of an overdose, seek emergency medical attention immediately. Always consult with your healthcare provider for personalized advice and before making any changes to your medication regimen.

Common side effects:

• Shaking
• Headaches
• Dizziness
• Nausea
• Vomiting
• Diarrhea
• Stomach upset
• Flushing
• Excessive hair growth
• Overgrowth and swelling of the gums
• High blood pressure

Less common but important to monitor:

• Urinary infections
• Viral infections
• General pain
• Muscle cramps
• Numbness or tingling in the arms or legs

Serious side effects:

• Signs of kidney problems
• Signs of liver disease
• Unusual tiredness
• Muscle weakness or spasms
• Slow or irregular heartbeat
• Severe leg pain
• Mental or mood changes
• Vision changes
• Speech difficulties
• Clumsiness
• Loss of coordination
• Seizures
• Severe allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Bosentan
• Colchicine
• Dronedarone
• Elagolix
• Eliglustat
• Grazoprevir
• Lercanidipine
• Mifepristone
• Pitavastatin
• Simvastatin
• Sitaxsentan

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Aliskiren
• Atorvastatin