Neoral 100mg

Cyclosporine is a generic form of brand name Neoral 100mg and the drug is a potent immunosuppressant drug used in treatment for rheumatoid arthritis, lupus, and other autoimmune diseases. Neoral 100mg is studied as disease modifying anti-rheumatic drug (DMARD) because it not only reduces the pain and swelling of arthritis, but it may also prohibit joint damage and decrease the risk of long term disability. Neoral 100mg is also admitted to less the progression of arthritis over time. Neoral is a prescription drug used under the guidance of medical practioners

Cyclosporine

Neoral

100mg

Novartis India




Neoral prescribed for

Neoral 100mg is indicated for the prevent rejection of a transplanted organ.

Neoral 100mg is also indicated to reduce inflammation in active rheumatoid arthritis and severe psoriasis.

Mechanism of action of Neoral 100mg

Cyclosporine targets to cyclophilin. The complex then prohibits calcineurin that is commonly responsible for stimulating transcription of interleukin 2. Cyclosporine also prevents lymphokine production and interleukin release. In ophthalmic applications, the actual mechanism of action is not known.

Cyclosporine emulsion is thought to work as a partial immunomodulator in patients whose tear results is presumed to be conceal due to ocular inflammation along with keratoconjunctivitis sicca.



ADME properties of Neoral 100mg

Incomplete and variable absorption from GI tract and bioavailability is 30% The time to high plasma concentration is 1.5-2.0 hours

Human plasma protein bound is 90%

In liver extensively metabolized by the cytochrome P450 3A enzyme system. To lesser degree is metabolized in gastrointestinal tract and kidney.

Primarily eliminated in biliary and in urine 6% and 0.1% excreted in urine as unchanged drug. Half-life in adults is 19 hours and in children is 7 hours




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Neoral 2000IU
Brand Neoral
Ingredients Cyclosporine
Strength 100mg
Manufactured Novartis India
Rating

Solid Organ Transplantation
Precaution of organ rejection in kidney, liver, and heart allogeneic transplants; has been needed in combination with azathioprine and corticosteroids

In Oral route
15 mg/kg orally for 1 dose required for 4-12 hours pre-transplant
15 mg/kg/day orally divided twice daily required for 1-2 weeks post-transplant
5-10 mg/kg/day orally divided twice daily required for reduce 5% per week until
In Intravenous (IV) route
5-6 mg/kg IV for 1 dose over 2-6 hours required for 4-12 hours pre-transplant IV
5-6 mg/kg IV once/day required for Post-transplant, until can tolerate oral therapy

Solid Organ Transplantation, Paediatric (Off-Label)
In 6 months, young children have getting Neoral to inhibit solid organ transplant rejection Dosage is same as adults, Even if children may necessary higher mg/kg dose than adults

In Oral route
15 mg/kg orally for 1 dose required for 4-12 hours pre-transplant
15 mg/kg/day orally divided twice daily required for 1-2 weeks post-transplant
5-10 mg/kg/day orally divided twice daily required for reduce 5% per week until
In Intravenous (IV) route
5-6 mg/kg IV for 1 dose over 2-6 hours required for 4-12 hours pre-transplant IV
5-6 mg/kg IV once/day required for Post-transplant, until can tolerate oral therapy

Rheumatoid Arthritis
Used for serious active, rheumatoid arthritis where the disease has not sufficient responded to methotrexate; may be needed in combination with methotrexate Neoral 1.25 mg/kg orally twice daily; may raise by 0.5-0.75 mg/kg/day after 8 weeks and again after 12 weeks if required, not to exceed 4 mg/kg/day Discontinue if no improvement observed by 16 weeks Reduce the dose by 25-50% at any time to regulate adverse effects (e.g., hypertension, elevations in serum creatine greater than 30% pre-treatment level

Psoriasis
Used for treatment of adult, non-immunocompromised patients with serious, recalcitrant, plaque psoriasis who have decline to respond to at least 1 systemic treatment(e.g., PUVA, retinoids, or methotrexate) or in patients for whom other systemic therapies are contraindicated, or may not be tolerated Cyclomune: 1.25 mg/kg orally twice daily; may raise by 0.5 mg/kg/day after 4 weeks and every 2 weeks if required, not to exceed 4 mg/kg/day Interrupt if no improvement seen at 6 weeks on maximum daily dose of 4 mg/kg/day Reduce the dose by 25-50% at any time to regulateside effects (e.g., high blood pressure, elevations in serum creatine greater than 30% pre-treatment level

Side effects caused by Neoral 100mg

Neoral 100mg will have some common and serious side effects after treatment, some are given below:

More common side effects
Hypertension, Magnesium level is low in body, In kidneys, blood clots occur, Stomach pain, Hair growth, Acne, Tremors, Headache, Gums size increased

Serious side effects
Liver damage - blood in urine; dark urine; pale stools; yellowing of your skin or the whites of your eyes; pain in your upper abdomen Kidney damage. Symptoms may include:blood in urine Heart problems. Symptoms may include:swelling of your feet or lower legs Lung problems. Symptoms may include:trouble breathing

Precautions

  • Neoral 100mg may have high risk of serious infections. It may also raise the risk of developing a tumor or skin cancer
  • Neoral 100mg weakens the immune system. If you administer this medication, you may be at higher risk for infections from bacteria, fungus, and viruses. These infections may be serious or life-threatening
  • If patient have psoriasis and have been treated with either psoralen plus ultraviolet A therapy, methotrexate, coal tar, radiation therapy, or ultraviolet light therapy, you may have a increased chance of occurring a skin disease while taking Neoral 100mg capsules.
  • Neoral 100mg medication may cause hypertension and renal disease.
  • Administrating Neoral 100mg may cause liver damage and liver failure, specifically if you take high doses. It may even be fatal.

DRUG – DRUG INTERACTION

  • Adalimumab interaction with Neoral both increase immunosuppressive effects and cause risk of infection. Avoid the usage of drug
  • Concomitant use with carbamazepine will reduce the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid the usage of drug or Use Alternate Drug.
  • Acyclovir combination with Neoral both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
  • Neoral 100mg increases levels of digoxin by reducing renal clearance. Avoid the usage of drug or Use Alternate Drug.
  • Azathioprine co administration with Neoral both increase immunosuppressive effects and cause risk of infection

Contraindications

Neoral 100mg is contraindicated to patients having; Hypersensitivity Breastfeeding Uses of Rheumatoid Arthritis (RA)/Psoriasis: Abnormal renal function, uncontrolled hypertension, malignancies Concomitant use of PUVA, UVB radiation, coal tar, methotrexate, other immunosuppressants will cause psoriasis



Neoral 100mg Pregnancy category is C
1) studies in animals has revealed adverse effects to the foetus when the mother takes the drug.
2) Have no enough research done in humans to be certain how the drug might affect the foetus.

Neoral 100mg passes through breast milk and may cause serious negative effects. Avoid using Neoral during breastfeeding.

Neoral 100mg stored at 20°-25° C Avoid the drug placing in moist or damp areas Protect away from light and high temperature

The patients decline to take a dose then immediately have the missed dose or skip the missed dose and follow regular schedule. Avoid taking extra dose Consult the doctor for more details

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