Cyclosporine

Say it: SYE-kloe-spor-een · Brand names: Sandimmune, Neoral, Gengraf

Cyclosporine is a medicine that calms the immune system so it does not attack a transplant or your own bone marrow.

What it is

Cyclosporine blocks a signal that T cells, a type of white blood cell, need to become active. With fewer active T cells, the immune system is calmer. This helps prevent rejection and graft-versus-host disease.

Often used for

• preventing graft-versus-host disease after a stem cell transplant
• aplastic anemia, often with antithymocyte globulin
• preventing rejection after a kidney, liver, or heart transplant
• some autoimmune conditions, such as rheumatoid arthritis and psoriasis

How you get it

Cyclosporine is usually a capsule or liquid you take by mouth twice a day. It can also be given through a vein (IV) in the hospital. It is often taken for months, and the dose is changed based on blood levels. Your schedule may be different.

Common side effects and what helps

• Higher blood pressure. Your team will check it, and you may need blood pressure medicine.
• Changes in kidney function. You will have blood tests often.
• Shaky hands (tremor). Tell your team if it gets worse.
• Extra hair growth on the face or body.
• Swollen or overgrown gums. Brush and floss gently every day and see a dentist.
• Headache, nausea, or upset stomach.
• Low magnesium or high potassium in the blood. Your team will check these.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Making much less urine than usual, or swelling in your legs
• A bad headache, confusion, seizure, or changes in your vision
• Very high blood pressure if you check it at home
• Yellow skin or eyes, or dark urine
• Signs of infection, such as cough, painful urination, or a sore that will not heal

Before you start, tell your team

• If you are pregnant, may become pregnant, or are breastfeeding
• If you have kidney or liver problems or high blood pressure
• If you have an infection or have had cancer
• ALL the medicines, vitamins, and herbal products you take. Many medicines, including some antibiotics, antifungals, seizure medicines, and St. John's wort, change cyclosporine levels
• Before starting any new medicine, even one from another doctor

Good to know

• You will have blood tests often to check the level of cyclosporine in your blood. Levels that are too high can harm the kidneys. Levels that are too low may not work.
• Grapefruit and grapefruit juice can raise cyclosporine levels. Avoid them.
• Different brands are not the same in the body. Do not switch between Sandimmune and Neoral or Gengraf unless your team tells you.
• It raises the risk of infections and of skin cancer and lymphoma. Protect your skin from the sun.
• Ask your team before getting any live vaccine, and before taking potassium supplements or salt substitutes.

At home

• Take it at the same times each day, about 12 hours apart, and the same way each day with or without food.
• Swallow capsules whole. If you take the liquid, use the measuring syringe that comes with it, and mix it only as your team or pharmacist tells you. Never mix it with grapefruit juice.
• On days you have a blood level test, ask your team if you should wait to take your dose until after the test.
• If you miss a dose, ask your care team what to do. Do not take two doses to make up for it.
• Store at room temperature in the original package, away from children and pets.

Questions to ask

• What blood level are we aiming for, and how often will it be checked?
• Which of my other medicines interact with cyclosporine?
• Should I check my blood pressure at home?
• How long will I need to take it?

Part of these treatment plans

• ATG and cyclosporine

Side effect guides

• Nausea and vomiting

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.