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Updated November 2019
Ciclosporin (brand names Cyclosporin, Cicloral, Neoral and Sandimmun) is a medicine used to treat rheumatoid arthritis and other conditions such as systemic lupus erythematosus (lupus/SLE), polymyositis (muscle inflammation), nephrotic syndrome (kidney inflammation) and severe skin conditions like psoriasis, atopic dermatitis (eczema) and pyoderma gangrenosum.
Ciclosporin is used in rheumatoid arthritis when other treatments have been unsuccessful. It is also used to prevent the rejection of transplanted organs or bone marrow
Ciclosporin is an immunosuppressive medicine, which means that it works by reducing the activity of the immune system. In rheumatoid arthritis, this action helps to reduce inflammation and thus reduce pain and swelling. It also limits damage to the joints and helps to prevent disability in the long term.
Because ciclosporin reduces the damage to the joints, rather than just relieving the pain, it belongs to the group of medicines called disease modifying antirheumatic drugs (DMARDS).
Ciclosporin may be of benefit where other DMARDs have been unsuccessful or have caused side effects.
Improvement in joint pain, swelling and stiffness may be seen after 4 weeks, but may be delayed for up to 4 months. If you stop ciclosporin treatment for more than a few weeks there is a risk that your condition may worsen. Continue with your treatment unless advised by your doctor or unless side effects develop.
Ciclosporin is taken by mouth, either as a liquid or capsules.
Capsules are the most convenient way of taking the medicine. They are available in four different strengths – 10 mg, 25mg, 50mg and 100mg. This means the dosage can be adjusted to suit your needs without you having to take large numbers of capsules.
Treatment is started with a low dose and is then increased depending on how effective the treatment is and whether you have side effects. A usual maintenance dose is 75 mg or 100 mg taken twice daily.
Do not chew the capsules but swallow whole with water.
Cyilosporin may be used with other arthritis medicines including:
There are separate information sheets for the medicines mentioned above on the ARA website.
You might experience side effects with your treatment. Tell your doctor if you are concerned about possible side effects.
A reduction in the dose may minimise side effects so that you can continue to take the treatment. Your doctor will advise on any dose changes that are necessary.
Use with other medicines and food