Sandimmun®capsules and oral solution are available
direct from Novartis for patients who cannot be
transferred to a different oral preparation.lPATIENT AND CARER ADVICEPatients and carers should be
counselled on the administration of different formulations
of ciclosporin.
Manufacturer advises avoid excessive exposure to UV
light, including sunlight. In psoriasis and atopic
dermatitis, avoid use of UVB or PUVA.
Medicines for Children leaflet: Ciclosporin for nephrotic syndrome
http://www.medicinesforchildren.org.uk/ciclosporin-nephrotic-
syndrome- 0
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for infusion
CAUTIONARY AND ADVISORY LABELS 11
EXCIPIENTS:May contain Alcohol, polyoxyl castor oils
▶Sandimmun(Novartis Pharmaceuticals UK Ltd)
Ciclosporin 50 mg per 1 mlSandimmun 250 mg/ 5 ml concentrate for
solution for infusion ampoules| 10 ampouleP£ 110. 05
Sandimmun 50 mg/ 1 ml concentrate for solution for infusion ampoules
| 10 ampouleP£ 23. 23
Oral solution
CAUTIONARY AND ADVISORY LABELS 11
EXCIPIENTS:May contain Alcohol, propylene glycol
▶Capsorin(Morningside Healthcare Ltd)
Ciclosporin 100 mg per 1 mlCapsorin 100 mg/ml oral solution sugar-
free| 50 mlP£ 86. 96
▶Neoral(Novartis Pharmaceuticals UK Ltd)
Ciclosporin 100 mg per 1 mlNeoral 100 mg/ml oral solution sugar-
free| 50 mlP£ 102. 30
▶Sandimmun(Novartis Pharmaceuticals UK Ltd)
Ciclosporin 100 mg per 1 mlSandimmun 100 mg/ml oral solution
sugar-free| 50 mlP£ 164. 72
Capsule
CAUTIONARY AND ADVISORY LABELS 11
EXCIPIENTS:May contain Ethanol, ethyl lactate, propylene glycol
▶Ciclosporin (Non-proprietary)
Ciclosporin 25 mgCiclosporin 25 mg capsules| 30 capsulePs
DT = £ 18. 37
Ciclosporin 50 mgCiclosporin 50 mg capsules| 30 capsulePs
DT = £ 35. 97
Ciclosporin 100 mgCiclosporin 100 mg capsules|
30 capsulePsDT = £ 68. 28
▶Capimune(Mylan)
Ciclosporin 25 mgCapimune 25 mg capsules| 30 capsuleP
£ 13. 05 DT = £ 18. 37
Ciclosporin 50 mgCapimune 50 mg capsules| 30 capsuleP
£ 25. 50 DT = £ 35. 97
Ciclosporin 100 mgCapimune 100 mg capsules| 30 capsuleP
£ 48. 50 DT = £ 68. 28
▶Capsorin(Morningside Healthcare Ltd)
Ciclosporin 25 mgCapsorin 25 mg capsules| 30 capsuleP
£ 11. 14 DT = £ 18. 37
Ciclosporin 50 mgCapsorin 50 mg capsules| 30 capsuleP
£ 21. 80 DT = £ 35. 97
Ciclosporin 100 mgCapsorin 100 mg capsules| 30 capsuleP
£ 41. 59 DT = £ 68. 28
▶Deximune(Dexcel-Pharma Ltd)
Ciclosporin 25 mgDeximune 25 mg capsules| 30 capsuleP
£ 13. 06 DT = £ 18. 37
Ciclosporin 50 mgDeximune 50 mg capsules| 30 capsuleP
£ 25. 60 DT = £ 35. 97
Ciclosporin 100 mgDeximune 100 mg capsules| 30 capsuleP
£ 48. 90 DT = £ 68. 28
▶Neoral(Novartis Pharmaceuticals UK Ltd)
Ciclosporin 10 mgNeoral 10 mg capsules| 60 capsuleP£ 18. 25
DT = £ 18. 25
Ciclosporin 25 mgNeoral 25 mg capsules| 30 capsuleP£ 18. 37
DT = £ 18. 37
Ciclosporin 50 mgNeoral 50 mg capsules| 30 capsuleP£ 35. 97
DT = £ 35. 97
Ciclosporin 100 mgNeoral 100 mg capsules| 30 capsuleP
£ 68. 28 DT = £ 68. 28
▶Sandimmun(Novartis Pharmaceuticals UK Ltd)
Ciclosporin 25 mgSandimmun 25 mg capsules| 30 capsuleP
£ 29. 58 DT = £ 18. 37
Ciclosporin 50 mgSandimmun 50 mg capsules| 30 capsuleP
£ 57. 92 DT = £ 35. 97
Ciclosporin 100 mgSandimmun 100 mg capsules| 30 capsuleP
£ 109. 93 DT = £ 68. 28
▶Vanquoral(Teva UK Ltd)
Ciclosporin 10 mgVanquoral 10 mg capsules| 60 capsuleP
£ 12. 75 DT = £ 18. 25
Ciclosporin 25 mgVanquoral 25 mg capsules| 30 capsuleP
£ 13. 05 DT = £ 18. 37
Ciclosporin 50 mgVanquoral 50 mg capsules| 30 capsuleP
£ 25. 59 DT = £ 35. 97
Ciclosporin 100 mgVanquoral 100 mg capsules| 30 capsuleP
£ 48. 89 DT = £ 68. 28Sirolimus 16-Nov-2017
lDRUG ACTIONSirolimus is a non-calcineurin inhibiting
immunosuppressant.lINDICATIONS AND DOSE
As a component of immunosuppressive therapy for renal
transplantation in children and adolescents only if
intolerance necessitates the withdrawal of a calcineurin
inhibitor
▶BY MOUTH
▶Child:(consult local protocol)
DOSE EQUIVALENCE AND CONVERSION
▶The 500 microgram tablet is not bioequivalent to the
1 mg and 2 mg tablets. Multiples of 500 microgram
tablets shouldnotbe used as a substitute for other
tablet strengths.lUNLICENSED USENot licensed for use in children.
lCAUTIONSHyperlipidaemia.increased susceptibility to
infection (especially urinary-tract infection).increased
susceptibility to lymphoma and other malignancies,
particularly of the skin (limit exposure to UV light)
lINTERACTIONS→Appendix 1 : sirolimus
lSIDE-EFFECTS
▶Common or very commonAbdominal pain.anaemia.
arthralgia.ascites.constipation.diabetes mellitus.
diarrhoea.dyslipidaemia.electrolyte imbalance.
embolism and thrombosis.fever.haemolytic uraemic
syndrome.haemorrhage.headache.healing impaired.
hyperglycaemia.hypertension.increased risk of infection
.leucopenia.lymphatic vessel disorders.menstrual cycle
irregularities.nausea.neoplasms.neutropenia.oedema.
osteonecrosis.ovarian cyst.pain.pancreatitis.
pericardial effusion.proteinuria.respiratory disorders.
sepsis.skin reactions.stomatitis.tachycardia.
thrombocytopenia
▶UncommonAntibiotic associated colitis.focal segmental
glomerulosclerosis.hepatic failure.nephrotic syndrome.
pancytopenia.post transplant lymphoproliferative
disorder
▶Frequency not knownPosterior reversible encephalopathy
syndrome (PRES)
lCONCEPTION AND CONTRACEPTIONEffective
contraception must be used during treatment and for
12 weeks after stopping.
lPREGNANCYAvoid unless essential—toxicity inanimal
studies.
lBREAST FEEDINGDiscontinue breast-feeding.
lHEPATIC IMPAIRMENT
Dose adjustmentsDose reduction may be necessary,
consult local treatment protocols for details.
MonitoringMonitor whole blood-sirolimus level closely
and consult local treatment protocol in hepatic
impairment.BNFC 2018 – 2019 Immune system disorders and transplantation 521
Immune system and malignant disease8