Sandimmune is an immunosuppressant primarily used to prevent rejection after organ transplant has been done. Its generic name is cyclosporine and was developed by Novartis. It is also used as treatment for psoriasis, atopic dermatitis and rheumatoid arthritis, but mostly all on severe cases only. It is currently unknown how it fully works, but it is suggested that it suppresses T-lymphocytes in the body. Sandimmune comes in 25mg and 100mg soft gelatin capsules, 100mg/ml oral solutions and 50ml/mg injections.
Sandimmune in capsule and in oral solution form are usually administered as injections are only reserved for those who cannot take the capsules or solution. An initial dose of 15mg/kg of body weight is given 4-12 hours after transplant operation. Succeeding doses are now favored to be lower than the initial dose, at around 10-14mg/kg and is further tapered off in the succeeding weeks. The current trend being prescribed by doctors now is to keep dosage as low as possible. While taking Sandimmune, it is recommended adrenal corticosteroids such as prednisone are administered in conjunction.
If taking the liquid solution, it may help to dilute it in milk, chocolate milk or orange juice in room temperature to make it more palatable., Use the same drink as much as possible every time when taking Sandimmune. Mix it well and drink it immediately, without letting it stand. It is advised to drink another glass of the diluents in the same container to ensure the entire dosage is consumed.
If using the injection, an initial dose of 5-6mg/kg in a single IV dose is given 4-12 hours after transplant. This is done by diluting 1ml of Sandimmune in 20-100ml 0.9% Sodium Chloride Solution or 5% Dextrose Solution. The patient is then advised to be switched to Sandimmune capsules or oral solution as soon as possible.
The doctor will need to test you blood for cyclosporine levels as its absorption by the body can be erratic, so it must be made sure that you are receiving the correct amount of the medication. Also, since you are taking an immunosuppressant, you will be more vulnerable to infections, and it is not advised to take Sandimmune along with other immunosuppressant drugs as it can compound the effects. Those who take Sandimmune for psoriasis treatment may be more susceptible to develop cancerous growths on the skin if you have previously undergone other forms of therapy for psoriasis.
Do not switch among brands of cyclosporine medication without your doctor’s consent as each brand may contain different amounts of cyclosporine. Inform your doctor of any other medication you are taking, as Sandimmune may interact with a large variety of other medications.
Sandimmune may cause kidney and liver problems as well as high blood pressure. Seek out help if you experience worsening symptoms of high blood pressure such as dizziness or fatigue.
You may also experience tremors, dark colored urine, swelling in the gums, unusual color and amount of urine or unusual bruising or bleeding. However if you feel dizziness, palpitations, numbing of hands and feet, shortness of breathing or a general feeling of illness consult your doctor.
Other side effects may take even years to present itself as an indirect result of taking immunosuppressant drugs. Consult your doctor to weigh these risks against the benefits.
Sandimmune has the following structural formula:
• Molecular formula of sandimmune is C62H111N11O12
• Chemical IUPAC Name is 30-ethyl-33-[(E,1R,2R)-1-hydroxy-2-methyl-hex-4-enyl]-1,4,7,10,12,15,19,25,28- nonamethyl-6,9,18,24-tetrakis(2-methylpropyl)-3,21-dipropan-2-yl-1,4,7,10,13,16, 19,22,25,28,31-undecazacyclotritriacontane-2,5,8,11,14,17,20,23,26,29,32-undecone
• Molecular weight is 1202.61 g/mol
• Sandimmune available : 25mg capsules, 100mg capsules
Generic name: Cyclosporine
Brand name(s): Gengraf, Neoral, Restasis
Review published on: 05 March 2009
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