The MGFA mission Common questions patients with myasthenia gravis ask about cyclosporine.What is cyclosporine?
Cyclosporine is an immunosuppressive medication that is sometimes prescribed
for individuals with autoimmune myasthenia gravis (MG). It is manufactured
as a capsule or an oral solution. You can purchase cyclosporine in generic form
or by the brand names Gengraf®, Neoral®, Sandimmune®, or SangCya®. How does cyclosporine work? Myasthenia Gravis Foundation of America, Inc.
and fatigable muscle weakness of MG. How soon should I see a response? Drugs that may cause kidney damage when combined with cyclosporine
• Antibiotics – gentamicin, tobramycin,
• Antifungals – amphotericin B
How is cyclosporine taken?
be used solely for educational purposes.
patient needs, and should not be used as
Cyclosporine must be taken exactly as
• Antivirals – acyclovir (Zovirax®)
• Antiulcer – cimetidine (Tagamet®),
condition. Instead, such decisions should
or health care professional who is directly
checking with your doctor. It is taken in
familiar with the patient. The information
contained in this publication reflects the
• Nonsteroidals (NSAIDS) – ibuprofen
views of the authors, but not necessarily
those of the Myasthenia Gravis Foundation
(Advil®, Motrin®, Nuprin®), diclofenac
not constitute an endorsement. MGFA, its
agents, employees, Directors, Chapters, its
milk or fruit juices, but not grapefruit
Medical/Scientific Advisory Board, and its
Mix the liquid form in a glass container
information contained in this publication.
They specifically disclaim any warranty of
merchantability, fitness for any particular
• Cardiac/Blood Pressure – captopril
information contained herein, and assume
no responsibility for any damage or liability
resulting from the use of such information. Drugs that may raise blood cyclosporine levels
interact with many other medicines,
Striving for a world without MG. Common questions patients with myasthenia gravis ask about cyclosporine.
• Antifungals – ketoconazole
(Nizoral®), difluconazole (Diflucan®),
• Any recent infections or immunizations.
• Stomach/Ulcer – metoclopramide
• Cardiac/Blood Pressure – diltiazem (Cardiazem®,
What are some special considerations when taking cyclosporine?
• Hormones – danazol (Danocrine®), oral
The physician wil check blood tests regularly
contraceptives, methylprednisolone (Medrol®)
to monitor for significant changes. BUN and
serum creatinine are checked before beginning
• Miscellaneous – bromocriptine (Parlodel®)
cyclosporine, than once a month for 3 months,
Drugs that may decrease cyclosporine levels
and then every 3 months. Cyclosporine blood
levels are performed one month after starting,
• Antibiotics – rifampin (Rifadin®, Rifamatev),
periodically thereafter, especially after a change
in dose. Blood levels are drawn 12 hours after the
last dose, preferably before the morning dose.
Cyclosporine may cause unwanted side effects,
• Anticonvulsants – phenytoin (Dilantin®),
some of which may be serious. Others may
Phenobarbital, carbamazepine (Tegretol®)
go away as your body adjusts to the drug. It is
Drugs that may accumulate in the blood
important to notify your health care providers
when taken with cyclosporine
about side effects. Al ergic reactions can be life
threatening and you should get emergency help at
• Steroids – prednisolone (Medrol®)
once. These include hives, severe itching, tightness
• Cardiac – digoxin (Lanoxin®)
in the neck or chest, trouble breathing, or swel ing
Other reactions that may occur
of the lips, tongue or throat. Also serious, are fever,
chil s, blood in the urine, and seizures. Careful
• Cholesterol – lovastatin (Mevacor®)
dental hygiene is important because cyclosporine
may cause gum swelling or bleeding. Other, more
• Cardiac/Blood Pressure – ACE inhibitors
common side effects may include acne, increased
(Accupril®, Altace®, Capoten®, Lotensin®,
hair growth, headache, nausea and vomiting.
Monopril®, Prinivil®, Vasotec®, Zestril®) may
What will my doctor want to know before prescribing cyclosporine? Since cyclosporine is a strong medicine, the
doctor and patient must consider its risks and
benefits. Your doctor will ask you about:• Current medications and treatments. • History of any allergies. • History of high blood pressure. • History of liver or kidney disease.
Riassunto L’encefalite erpetica (HSE) rappresenta una delle patologie infettive del sistema nervoso centrale (SNC) con più alto tasso di letalità e morbilità. La sintomatologia evolve in diversi giorni e è solitamente simile a quella di qualsiasi altra forma di encefalite acuta. La diagnosi di HSE si basa sulla ricerca di HSV-DNA nel liquor (sensibilità 95% e specificità 98%). Il DNA vi