Indications  

Sandimmune is a prescribed medication used alongside adrenal corticosteroids to prevent the rejection of transplanted organs, such as kidneys, liver, and heart. 

Sandimmune is also indicated for the treatment of chronic rejection in patients who have received prior treatment with alternative immunosuppressive agents. 

As an immunosuppressant, Sandimmune functions by reducing the strength of the immune system, enabling the body to accept the transplanted organ as if it were naturally part of it. 

Uses and Dosage 

Before starting treatment with Sandimmune and with each prescription refill, carefully review its medication guide and patient information leaflet. If you have any concerns, do not hesitate to seek advice from your healthcare provider or pharmacist. 

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

Typically, this medication is taken once daily, as prescribed by the doctor. It can be taken with or without food but selecting one method and maintaining consistency with each dose is crucial. 

For optimal results, take Sandimmune exactly as directed at a consistent time each day. Refrain from altering the prescribed dosage, frequency, and duration of intake without your doctor’s approval. 

Side Effects 

Listed below are the potential adverse effects of Sandimmune. Tell your doctor right away if any of them persists or worsens. 

Common Side Effects 

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

Serious Side Effects 

• Change in mental state, speech or walking problems, decreased vision (may start gradually 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 
• Signs of 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 
• Indications of high potassium: 
  • Nausea 
  • Slow or unusual heart rate 
  • Weakness 
  • Loss of movement 
• Signs of kidney problems: 
  • Little or no urination 
  • Painful or difficult urination 
  • Swelling in feet or ankles 
  • Fatigue 
  • Shortness of breath 
• Indications of liver problems: 
  • Nausea 
  • Upper stomach pain 
  • Itching 
  • Fatigue 
  • Loss of appetite 
  • Dark urine 
  • Clay-colored stools 
  • Jaundice (yellowing of skin or eyes) 
• Signs of infection: 
  • Fever 
  • Chills 
  • Flu-like symptoms 
  • Mouth sores 
  • Skin sores 
  • Feeling light-headed 
  • Short of breath 
  • Rapid heart rate 

Contact your doctor right away if you encounter any of the serious side effects listed above. 

Allergic Reactions 

Although rare, a severe allergic reaction to Sandimmune may occur. Seek immediate medical help if you encounter any signs of an allergic response, such as: 

• Hives 
• Face, lips, tongue, or throat swelling 
• Breathing difficulties 

Not all side effects of Sandimmune are included in this list. Inform your doctor if any unlisted effects occur. 

Cautions 

Before starting treatment with Sandimmune, inform your doctor if you have any known allergies, particularly to cyclosporine or other medications. 

Consult your pharmacist for additional information about Sandimmune, as it may contain inactive ingredients that may trigger allergic reactions or other complications. 

To ensure Sandimmune 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 cause 
• Radiation treatment (including light treatment with PUVA or UVB) 
• Mineral imbalance (e.g., low magnesium or high potassium levels) 
• Recent/current infections 
• High cholesterol/triglyceride levels 

Notify all your healthcare providers of any current or recently started or stopped medications, including prescription and over-the-counter drugs, vitamins, and herbal supplements, to minimize the risk of drug interaction with Sandimmune. 

Some of the products that may interact with Sandimmune include: 

• Coal tar 
• Orlistat 
• Other drugs that weaken the immune system/increase infection risk (e.g., natalizumab, rituximab, tofacitinib) 
• Drugs that may increase potassium levels (e.g., potassium supplements, certain diuretics/ “water pills” including amiloride, spironolactone) 
• Tacrolimus 

The effectiveness of Sandimmune may be altered by other drugs that impact its elimination from the body, such as: 

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

Sandimmune has the potential to impede the elimination of certain medications from the system, thereby potentially altering their efficacy. This includes drugs like: 

• Aliskiren 
• Dabigatran 
• Dronedarone 
• Elagolix 
• Specific statins (e.g., pitavastatin, simvastatin) 
• Voxilaprevir 

During Sandimmune treatment, refrain from consuming grapefruit or grapefruit juice as they can interact with the medication and cause undesirable side effects. 

Prior to using potassium supplements or salt substitutes containing potassium, seek advice from your doctor or pharmacist, as Sandimmune may elevate potassium levels. 

Before receiving any immunizations/vaccinations, inform your healthcare professional about your use of Sandimmune. Avoid contact with individuals who have recently received live vaccines, such as the flu vaccine inhaled through the nose. 

Sandimmune increases the risk of infections or may worsen existing ones. Avoid contact with individuals who have contagious infections (like chickenpox, COVID-19, measles, and flu). Consult your doctor if you have been exposed to an infection or need further information. 

The use of Sandimmune may lower infection-fighting blood cells or result in excessive production of certain white blood cells. This could lead to severe, even fatal conditions like cancer, brain infections causing disability or death, or a virus affecting the transplanted kidney. Consult your doctor to assess your risk. 

Minimize exposure to sunlight or tanning beds while taking Sandimmune as it increases susceptibility to sunburn. Utilize protective garments and apply sunscreen with an SPF of 30 or above when outside. 

The potential effects of Sandimmune on an unborn child are uncertain. Inform your doctor if you are pregnant or intend to become pregnant. 

Cyclosporine has the potential to transfer to breast milk and cause harm to a nursing infant. Therefore, breastfeeding is not recommended while taking Sandimmune.