Neoral 25 mg Capsule (1 Strip = 5 Pieces)
Original price was: 475.00৳ .451.25৳ Current price is: 451.25৳ .
Neoral 25 mg contains ciclosporin, an immunosuppressant that lowers the activity of the body’s immune system. It is mainly used to stop the body from rejecting a transplanted organ or bone marrow. It is also used for some severe autoimmune and inflammatory conditions that haven’t responded to standard treatment. Neoral is a microemulsion form of ciclosporin, which makes absorption more consistent than with older ciclosporin formulations.
Indications
Transplantation:
- Preventing rejection after kidney, liver, heart, lung, heart-lung or pancreas transplants
- Treating rejection in patients who were previously on other immunosuppressants
- Bone marrow transplantation: preventing graft rejection, and preventing and treating graft-versus-host disease (GVHD)
Non-transplant conditions:
- Endogenous uveitis (sight-threatening, non-infectious)
- Steroid-dependent or steroid-resistant nephrotic syndrome
- Severe active rheumatoid arthritis
- Severe psoriasis that hasn’t responded to conventional treatment
- Severe atopic dermatitis (eczema)
How it works
Ciclosporin is a calcineurin inhibitor. It blocks the activation of T-lymphocytes, the white blood cells that drive immune rejection and inflammation, by suppressing the production of interleukin-2 and other cytokines. This reduces the immune response against transplanted tissue and calms overactive immune activity in autoimmune diseases. Unlike many immunosuppressants, it does not suppress the bone marrow.
Dosage and administration
Neoral must only be started and adjusted by a physician experienced in immunosuppressive therapy. The dose depends on body weight (mg/kg), the condition being treated, and blood ciclosporin levels.
Usual dose ranges:
- Organ transplantation: 10–15 mg/kg/day in 2 divided doses, starting 12 hours before surgery. This is gradually reduced to a maintenance dose of about 2–6 mg/kg/day, guided by blood levels.
- Bone marrow transplantation: 12.5–15 mg/kg/day, starting the day before the transplant.
- Psoriasis: 2.5 mg/kg/day, which can be increased to a maximum of 5 mg/kg/day.
- Atopic dermatitis: 2.5–5 mg/kg/day, usually for up to 8 weeks.
- Rheumatoid arthritis: 3 mg/kg/day for the first 6 weeks, which can be increased to a maximum of 5 mg/kg/day.
- Nephrotic syndrome: 5 mg/kg/day for adults and 6 mg/kg/day for children.
- Uveitis: 5–7 mg/kg/day.
How to take:
- Take the total daily dose in 2 divided doses, about 12 hours apart.
- Take it at the same times each day and in the same relation to meals (always with food, or always without).
- Swallow the capsules whole with water.
- Do not take with grapefruit or grapefruit juice. It raises ciclosporin levels in the blood.
- Your doctor will check blood ciclosporin levels, kidney function, blood pressure and blood tests regularly.
- Do not switch between Neoral and other ciclosporin brands or formulations without your doctor’s supervision. They are not automatically interchangeable.
Contraindications
- Hypersensitivity to ciclosporin or any ingredient of the capsule
- Taking it together with St John’s Wort (Hypericum perforatum), dabigatran, bosentan or aliskiren
- For non-transplant uses: abnormal kidney function, uncontrolled high blood pressure, uncontrolled infections, or any type of cancer
Side effects
Very common:
- Kidney problems, high blood pressure
- Tremor, headache
- Raised blood lipids
Common:
- Excess hair growth (hirsutism), gum overgrowth (gingival hyperplasia)
- Nausea, vomiting, diarrhoea, stomach pain, loss of appetite
- Tingling or burning in the hands and feet, tiredness, muscle cramps
- High potassium, low magnesium, raised uric acid
- Liver function changes, acne, fever
Pregnancy and breastfeeding
- Pregnancy: Use only if the expected benefit clearly outweighs the possible risk, and only under specialist supervision.
- Breastfeeding: Ciclosporin passes into breast milk, so breastfeeding is not recommended during treatment.
Storage
Store below 30°C in a dry place. Keep the capsules in the blister until use. A slight characteristic smell when you open the blister is normal. Keep out of the reach of children.
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