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Cyclosporine is a medication that requires careful usage due to its potential risks and the need for monitoring. Below are important safety and warning details to consider when using cyclosporine:

• Infection Risk: Cyclosporine weakens your immune system, increasing your susceptibility to infections, which can become severe or life-threatening. This can include opportunistic infections that typically affect individuals with compromised immune systems. Report any signs of infection such as persistent sore throat, fever, chills, or cough to your healthcare provider immediately.

• Cancer Risk: The suppression of the immune system by cyclosporine can elevate the risk of developing cancers, including lymphomas and skin cancer. This risk is heightened in individuals with a history of cancer, those undergoing phototherapy, or those exposed to significant sunlight or UV light.

• Blood Pressure and Kidney Concerns: Cyclosporine can cause high blood pressure and kidney damage, particularly at higher doses or with prolonged use. Regular monitoring of blood pressure and kidney function by your healthcare provider is essential.

• Liver and Brain Risks: There is a risk of liver damage, which can be severe, especially with long-term or high-dose use. Similarly, brain damage, potentially exacerbated by high steroid doses, can occur but is often reversible upon discontinuation of the medication.

• Hematological Effects: Low platelet and red blood cell counts are possible but rare side effects. These can have serious implications, especially post-transplant.

• Electrolyte Imbalances: Some individuals may experience high potassium or uric acid levels, leading to symptoms such as fatigue, muscle weakness, or heart issues. Notify your healthcare provider if you have symptoms like a fast heartbeat or chest pain.

• Alcohol Content: Cyclosporine contains alcohol, which may not be suitable for pregnant or breastfeeding individuals, those with liver issues, or a history of seizures. It's important to disclose any alcohol consumption or history of alcohol use disorder to your healthcare provider.

• Medication Interactions: Different brands of cyclosporine (such as Neoral and Sandimmune) are not interchangeable due to differences in absorption. Switching brands without medical guidance can lead to adverse effects.

• Specific Populations: Special caution is advised for individuals with pre-existing conditions such as kidney or liver problems, uncontrolled high blood pressure, or a history of certain cancers. Pregnant or breastfeeding individuals should discuss potential risks with their healthcare provider.

In cases of overdose or severe adverse reactions, seek emergency medical attention immediately. Always consult your healthcare provider for personalized advice and before making any changes to your medication regimen.

When taking this medication, you might experience some common side effects, which are generally mild and manageable. These include shaking, headaches, dizziness, nausea, vomiting, diarrhea, stomach upset, and flushing. It's also possible to notice unusual growth of body hair, particularly on the face, back, and chest, as well as swelling or overgrowth of the gums. Regular dental care, such as brushing and flossing, can help manage gum changes. If these effects persist or worsen, contact a healthcare professional for advice.

High blood pressure is another potential side effect, so it's important to monitor your pressure regularly. While some users might experience urinary or viral infections, these are typically infrequent. More serious side effects require immediate attention. These include signs of kidney problems, such as changes in urine volume, signs of liver issues, unexplained bruising or bleeding, extreme tiredness, muscle weakness, irregular heartbeat, numbness, or severe leg pain.

In rare cases, very serious allergic reactions can occur, marked by symptoms like rash, swelling of the face or throat, severe dizziness, or trouble breathing. Immediate medical help is necessary if you notice any mental or mood changes, vision problems, speech difficulties, loss of coordination, one-sided body weakness, seizures, or chest pain. While these severe side effects are uncommon, it's crucial to remain vigilant and seek medical help if they arise.

When taking cyclosporine (Neoral), be aware of potential interactions with other medications and supplements. Inform your healthcare provider about all drugs and supplements you are using, including those prescribed, over-the-counter, vitamins, and herbal remedies. Some products that can influence cyclosporine's effectiveness or increase health risks include:

1. Medications to Avoid Completely: Certain drugs should not be used with cyclosporine due to significant interactions. These include bosentan, colchicine, dronedarone, elagolix, eliglustat, grazoprevir, lercanidipine, mifepristone, pitavastatin, simvastatin, and sitaxsentan.

2. Medications Usually Not Recommended: Some medications may require careful consideration and dose adjustments if used with cyclosporine. These include abametapir, acalabrutinib, aceclofenac, afatinib, amlodipine, aspirin, atorvastatin, and many others. Your doctor may need to adjust the dosage or frequency of these drugs if co-prescribed.

3. Medications with Increased Side Effect Risk: Using cyclosporine with certain drugs may elevate the risk of side effects. Nonetheless, such combinations might be necessary for optimal treatment. Medications in this category include acetazolamide, allopurinol, amiodarone, amphotericin B, apixaban, azathioprine, and more. Your healthcare provider may modify your treatment plan to manage these interactions.

Additionally, some drugs can alter how cyclosporine is eliminated from your body, affecting its efficacy. Conversely, cyclosporine may slow the clearance of other drugs, influencing their effectiveness. Examples include aliskiren, dabigatran, and certain statins. Always follow your healthcare provider's guidance when managing these potential interactions.