Indications 

Neoral is a prescribed medication used to prevent organ rejection in individuals who have undergone liver, kidney, or heart transplantation. It is typically administered alongside other drugs to facilitate the proper functioning of the new organ. 

This medication is also prescribed for the management of severe rheumatoid arthritis (inflammation of joint linings) and plaque psoriasis (a skin condition characterized by red, scaly patches on the body). 

As an immunosuppressant medication, Neoral works by weakening the immune system to facilitate acceptance of the transplanted organ as part of the body (in the case of transplantation) and to prevent joint or skin damage (in the case of rheumatoid arthritis or psoriasis). 

Uses and Dosage 

Before taking Neoral and with each prescription refill, carefully review its medication guide and patient information leaflet. If you have any questions or uncertainties, consult your physician or pharmacist. 

The dosage of Neoral is determined based on the patient’s weight, medical condition, laboratory test results, and response to the treatment. 

Typically, Neoral is taken twice a day as prescribed by the doctor. It can be taken with or without food, but it should be consistently taken in the same manner each time. 

For optimal results, take this medication at a consistent time daily. Do not alter the prescribed dosage and frequency of intake without consulting your doctor. 

Side Effects 

Listed below are the potential adverse effects of Neoral. Inform your doctor promptly if any of them persist or deteriorate. 

Common Side Effects 

• Tremors or shaking 
• Acne 
• Increased growth of facial or body hair 
• Increased blood pressure 
• Nausea 
• Diarrhea 
• Swollen or painful gums 

Serious Side Effects 

• Change in mental state, speech or walking difficulties, decreased vision (may have a gradual onset and worsen rapidly) 
• Easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under the skin 
• Pale or yellowed skin, dark colored urine, fever, confusion, or weakness 
• Dangerously high blood pressure: 
  • Severe headache 
  • Blurred vision 
  • Pounding in the neck or ears 
  • Nosebleed 
  • Anxiety 
  • Confusion 
  • Severe chest pain 
  • Shortness of breath 
  • Irregular heartbeats 
• High potassium levels: 
  • Nausea 
  • Slow or irregular heart rate 
  • Weakness 
  • Loss of movement 
• Kidney problems: 
  • Reduced or no urination 
  • Painful or difficult urination 
  • Swelling in the feet or ankles 
  • Fatigue 
  • Shortness of breath 
• Liver problems: 
  • Nausea 
  • Upper abdominal pain 
  • Itching 
  • Fatigue 
  • Loss of appetite 
  • Dark urine 
  • Clay-colored stools 
  • Jaundice (yellowing of the skin or eyes) 
• Signs of infection:  
  • Fever 
  • Chills 
  • Flu-like symptoms 
  • Mouth sores 
  • Skin sores 
  • Feeling light-headed or short of breath 
  • Rapid heart rate 

Call your doctor right away if any of the following severe side effects are experienced. 

Allergic Reactions 

Although rare, a severe allergic reaction to Neoral may occur. Seek immediate medical help if any of the following symptoms arise: 

• Rash 
• Itching or swelling of the face, tongue, or throat 
• Severe dizziness 
• Trouble breathing  

This list does not contain all the potential side effects of Neoral. If any unlisted effects occur, tell your doctor promptly. 

Cautions 

Before starting treatment with Neoral, inform your doctor and pharmacist if you have any known hypersensitivities, especially to cyclosporine, other medications, or any of the ingredients present in Neoral capsules. 

To ensure Neoral is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Kidney disease 
• Liver disease 
• High blood pressure 
• Cancer 
• Skin lesions of unknown origin 
• Radiation treatment (e.g., PUVA or UVB light therapy) 
• Mineral imbalance (e.g., low magnesium or high potassium levels) 
• Recent or current infections 
• High cholesterol/triglyceride levels 

Tell your doctor and pharmacist about all medications, vitamins, supplements, and herbal products you are currently or planning to use, to lower the risk of drug interaction with Neoral. 

Some of the products that may interact with Neoral include: 

• Coal tar 
• Orlistat 
• Other immune-suppressing or infection-risk-increasing drugs: 
  • Natalizumab 
  • Rituximab 
  • Tofacitinib 
• Drugs that may elevate potassium levels: 
  • Potassium supplements 
  • Specific diuretics like amiloride or spironolactone 
• Tacrolimus 

The effectiveness of Neoral may be altered by other drugs that impact its elimination, such as: 

• Bosentan 
• Mifepristone 
• St. John’s wort 
• Ritonavir 

Neoral can interfere with the metabolism of other medications, leading to altered efficacy. Drugs that may be impacted include: 

• Aliskiren 
• Dabigatran 
• Dronedarone 
• Elagolix 
• Select statins (pitavastatin, simvastatin) 
• Voxilaprevir 

The consumption of grapefruit and grapefruit juice may result in interactions with Neoral, potentially causing undesirable side effects. Refrain from using grapefruit products while taking this medication. 

Consult your doctor or pharmacist before taking potassium supplements or salt substitutes containing potassium, as Neoral may elevate your potassium levels. 

Inform your healthcare provider of your Neoral use prior to receiving any immunizations. Refrain from being close to individuals who have recently received live vaccines, such as the nasal flu vaccine. 

The use of Neoral increases susceptibility to infections and exacerbates existing ones. Avoid contact with individuals who have contagious illnesses like chickenpox, COVID-19, measles, or the flu. Consult your physician if you have been exposed to an infection or need further information. 

Neoral may decrease immune cells that aid in fighting infections or induce excessive production of a particular type of white blood cells. This can result in severe and potentially fatal illnesses, such as cancer, a debilitating brain infection, or a virus that may cause kidney transplant failure. Consult with your physician to determine your risk. 

Neoral increases susceptibility to sunburn. Take precautions by avoiding direct sunlight and tanning beds. Wear protective clothing and apply sunscreen with SPF 30 or higher when outdoors. 

Neoral has the potential to cause dizziness. Do not operate vehicles, use machinery, or engage in activities requiring alertness until you can safely do so. 

Neoral may contain alcohol. If you are pregnant, breastfeeding, have liver disease, alcohol dependence, or any other condition that necessitates alcohol restriction or avoidance in your diet, caution is advised. Consult your doctor or pharmacist for guidance on using this product safely. 

Neoral is contraindicated during pregnancy unless the maternal benefit outweighs the fetal risk. 

Cyclosporine can potentially transfer into breast milk and harm a nursing baby. Refrain from breastfeeding while taking this medication.