• Organ rejection prophylaxis

Sandimmune Generic Name & Formulations

General Description

Cyclosporine 25mg, 100mg; soft gel caps; contains alcohol.

Pharmacological Class


How Supplied

Caps—3x10 blister cards; Soln—50mL; Inj (5mL)—10

Sandimmune Indications


Organ rejection prophylaxis in kidney, liver, and heart allogeneic transplants, in combination with corticosteroids. Treatment of chronic rejection in patients previously treated with other immunosuppressants. IV: reserved for patients who are unable to take caps or oral soln.

Sandimmune Dosage and Administration


Give consistently with regard to meals and time of day. Initially 15mg/kg as a single dose given 4–12hrs prior to transplantation. Continue initial daily dose for 1–2wks post-op then taper by 5% per week to maintenance dose of 5–10mg/kg/day. Adjunct corticosteroid therapy is recommended. Oral soln: dilute with room temp milk, chocolate milk, or orange juice before administration; avoid switching diluents frequently. Conversion from Neoral, blood concentration monitoring: see full labeling.


See full labeling.

Sandimmune Contraindications


IV: hypersensitivity to Cremophor EL.

Sandimmune Boxed Warnings

Boxed Warning

Prescribe only by physicians experienced in immunosuppressive therapy. May increase risk of infections, lymphomas and other malignancies. Decreased bioavailability compared to Neoral; do not use interchangeably.

Sandimmune Warnings/Precautions


Be fully familiar with immunosuppressive therapy before prescribing. Not bioequivalent to all other forms of cyclosporine; do not interchange without physician supervision. Increased risk of infections, lymphomas and other malignancies (eg, skin). Monitor BP, renal and hepatic function. Control hypertension if develops. Malabsorption. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.

Sandimmune Pharmacokinetics

See Literature

Sandimmune Interactions


Avoid other nephrotoxic drugs (eg, ciprofloxacin, gentamicin, tobramycin, vancomycin, SMX/TMP, melphalan, amphotericin B, ketoconazole, cimetidine, ranitidine, tacrolimus, NSAIDs, colchicine), fibric acid derivatives, methotrexate. Cyclosporine levels increased by CYP3A inhibitors (eg, calcium channel blockers, amiodarone, azithromycin, azole antifungals, erythromycin, clarithromycin, quinupristin/dalfopristin, boceprevir, telaprevir, methylprednisolone, allopurinol, colchicine, bromocriptine, danazol, metoclopramide, probably indinavir, saquinavir, nelfinavir, ritonavir, imatinib, nefazodone, oral contraceptives). Avoid alcohol, grapefruit juice. Cyclosporine levels decreased by CYP3A inducers (eg, nafcillin, rifampin, carbamazepine, oxcarbazepine, bosentan (avoid), phenobarbital, phenytoin, octreotide, sulfinpyrazone, terbinafine, ticlopidine, St. John's wort), orlistat. Avoid potassium-sparing diuretics. Caution with concomitant rifabutin. Concomitant repaglinide: monitor blood glucose. Concomitant aliskiren: not recommended. Concomitant sirolimus: separate by 4 hours. May decrease effectiveness of vaccines; avoid live attenuated vaccines. May increase levels of digoxin (monitor), colchicine, statins (reduce dose), ambrisentan, and anthracycline antibiotics, dabigatran (avoid). Gingival hyperplasia with nifedipine. Convulsions with high-dose methylprednisolone.

Sandimmune Adverse Reactions

Adverse Reactions

Renal dysfunction, tremor, hirsutism, hypertension, gum hyperplasia, cramps, convulsions, headache, diarrhea, nausea, vomiting; increased risk of infections or malignancies, progressive multifocal leukoencephalopathy, polyoma virus-associated nephropathy, hypomagnesemia, hyperkalemia, hyperuricemia, thrombotic microangiopathy, hepatotoxicity, neurotoxicity; IV: anaphylactic reactions.

Sandimmune Clinical Trials

See Literature

Sandimmune Note

Not Applicable

Sandimmune Patient Counseling

See Literature