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All about: Neoral Solution

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Generic Name: Cyclosporine Oral Solution, Modified (SYE-kloe-spor-een)
Brand Name: Examples include Gengraf and Neoral

Neoral Solution suppresses the immune system, which may increase your risk of developing an infection or cancer. In kidney, liver, or heart transplant patients, Neoral Solution may be used along with other medicines that suppress the immune system. Using these medicines together may further increase your risk of developing an infection or a certain type of cancer (lymphoma).

Neoral Solution cannot be interchanged with other forms of cyclosporine (eg, Sandimmune) without your doctor's approval. If you are taking Neoral Solution for a transplant or for rheumatoid arthritis, lab tests may be performed to monitor your progress or to check for side effects such as toxicity.

If you are using Neoral Solution for psoriasis and you are also using certain other forms of treatment (eg, psoralen ultraviolet A [PUVA] or ultraviolet B [UVB] therapy, medicines that suppress the immune system, coal tar, radiation therapy), you may be at an increased risk for developing skin cancer.

Neoral Solution may cause high blood pressure or kidney problems. This risk may be increased with high doses or prolonged use of Neoral Solution. Kidney function tests may be performed while you are taking Neoral Solution to check for side effects.


Neoral Solution is used for:

Preventing the rejection of organ transplants (kidney, liver, and heart). Neoral Solution is also used to treat psoriasis and rheumatoid arthritis in certain patients. It may also be used for other conditions as determined by your doctor.

Neoral Solution is an immunosuppressant. How Neoral Solution works is not fully understood, but it may block certain white blood cells.

Do NOT use Neoral Solution if:

  • you are allergic to any ingredient in Neoral Solution
  • you are taking bosentan, disulfiram, fluorouracil, metronidazole, orlistat, or a potassium-sparing diuretic (eg, spironolactone)
  • you have psoriasis or rheumatoid arthritis and also have kidney problems, uncontrolled high blood pressure, or cancer
  • you are using other therapies for psoriasis (eg, PUVA or UVB therapy, methotrexate or other medicines that suppress the immune system, coal tar, radiation therapy)
  • you are going to be vaccinated with a live vaccine

Contact your doctor or health care provider right away if any of these apply to you.

Before using Neoral Solution:

Some medical conditions may interact with Neoral Solution. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have liver, kidney, brain, or nerve problems; high blood potassium or uric acid levels; low blood magnesium or cholesterol levels; high blood pressure; cancer; an infection; or problems absorbing food or medicine; or have had a recent vaccination
  • if your diet contains a lot of potassium
  • if you have a history of seizures

Some MEDICINES MAY INTERACT with Neoral Solution. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Many prescription and nonprescription medicines (eg, used for infections, inflammation, aches and pains, high blood pressure, cancer, gout, diabetes, heartburn, high cholesterol, irregular heartbeat or other heart problems, birth control, Parkinson disease, stomach and intestinal problems, endometriosis, HIV, seizures, blood clotting, weight loss, arthritis, psoriasis, depression, sleep, other conditions), multivitamin products, and herbal or dietary supplements (eg, St. John's wort) may interact with Neoral Solution. They may increase the risk of side effects or decrease the effectiveness of this or other medicines
  • Potassium-sparing diuretics (eg, spironolactone) because the risk of high blood potassium levels may be increased
  • Bosentan because the risk of its side effects and toxic effects may be increased by Neoral Solution
  • Orlistat because it may decrease Neoral Solution's effectiveness
  • Disulfiram, fluorouracil, or metronidazole because flushing, headache, fast or irregular heartbeat, shortness of breath, nausea, or vomiting may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Neoral Solution may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Neoral Solution:

Use Neoral Solution as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Neoral Solution on a regular schedule with regard to food and time of day.
  • Do not eat grapefruit or drink grapefruit juice while you use Neoral Solution.
  • If you also take sirolimus, do not take it within 4 hours after taking Neoral Solution. Check with your doctor if you have questions.
  • Follow your doctor's instructions on how to dilute Neoral Solution. Use a glass container to mix Neoral Solution. To improve the flavor, Neoral Solution may be mixed with room temperature orange or apple juice. Certain brands of Neoral Solution should not be taken with apple juice; check with your doctor or pharmacist.
  • Avoid frequently switching the liquid that you use to mix Neoral Solution in. Stir well and drink immediately (do not let it stand before drinking). Rinse glass with more liquid and drink again to make sure the entire dose is taken.
  • Do not rinse the dosing syringe with water or other cleaning agents. This will affect the dose. If the syringe needs to be cleaned, it must be completely dry before it is used again.
  • If you miss a dose of Neoral Solution, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Neoral Solution.

Important safety information:

  • Neoral Solution may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Neoral Solution with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not switch to another doseform or change brands of Neoral Solution without talking to your doctor. Products made by other companies may not work as well for you.
  • Neoral Solution may increase your risk of skin cancer. Avoid the sun, sunlamps, or tanning booths until you know how you react to Neoral Solution. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Neoral Solution may increase your risk of developing certain forms of cancer. Discuss any questions or concerns with your doctor.
  • Do not receive a live vaccine (eg, measles, mumps) while you are taking Neoral Solution. Talk with your doctor before you receive any vaccine.
  • Check with your doctor before you use a salt substitute or a product that has potassium in it.
  • Neoral Solution may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills.
  • Tell your doctor or dentist that you take Neoral Solution before you receive any medical or dental care, emergency care, or surgery.
  • Patients who are being treated for psoriasis will need to have careful skin and physical examinations, including blood pressure measurements, before starting this medication.
  • Diabetes patients - Neoral Solution may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Lab tests, including kidney and liver function tests; cyclosporine levels; and blood pressure, lipids, and electrolytes, may be performed while you use Neoral Solution. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use Neoral Solution with caution in the ELDERLY; they may be more sensitive to its effects.
  • PREGNANCY and BREAST-FEEDING: Neoral Solution may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Neoral Solution while you are pregnant. Neoral Solution is found in breast milk. Do not breast-feed while taking Neoral Solution.

Possible side effects of Neoral Solution:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Acne; burning sensation; coughing; dizziness; flushing; increased hair growth; headache; nausea; runny nose; sleeplessness; stomach discomfort; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); black, tarry stool; blood in the urine; chest pain; chills; confusion; dark urine; diarrhea; fast or irregular heartbeat; fever; gum disease or overgrowth; increased or decreased urination; infection; loss of coordination; mental or mood changes; muscle cramps; numbness or tingling of the skin; seizures; severe or persistent headache or dizziness; shortness of breath; sore throat; tremors; unusual bleeding or bruising; unusual lumps; unusual thickening or lesion of the skin; unusual tiredness or weakness; vision changes; wheezing; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately.

Proper storage of Neoral Solution:

Store Neoral Solution at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in the original container. Store away from heat, moisture, and light. Do not refrigerate. Use contents within 2 months of opening. If stored below 68 degrees F (20 degrees C), the solution may gel or become cloudy. This will not affect the product. If this occurs, bring it to room temperature (77 degrees F; 25 degrees C). Do not store in the bathroom. Keep Neoral Solution out of the reach of children and away from pets.

General information:

  • If you have any questions about Neoral Solution, please talk with your doctor, pharmacist, or other health care provider.
  • Neoral Solution is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Neoral Solution. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition 07.3.1.003
Copyright © 2007 Wolters Kluwer Health, Inc.

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