Cyclosporine (Neoral, Sandimmune, Gengraf)
Cyclosporine (Neoral, Sandimmune, Gengraf) is a medicine used to treat autoimmune diseases including rheumatoid arthritis, lupus, psoriasis, Behçet’s, and dermatomyositis. Cyclosporine was originally developed to prevent rejection of transplanted organs. However, it has proven effective as a treatment for autoimmune diseases which have not responded well to other medications. Cyclosporine can also be used to treat some pediatric rheumatologic conditions, most commonly for the management of juvenile dermatomyositis and macrophage activation syndrome associated with systemic juvenile idiopathic arthritis.
How To Take It
Cyclosporine comes in pill form and is taken by mouth one or two times per day. Your rheumatology provider will discuss the dose with you based on your body weight and condition that is being treated. The capsules should not be crushed or chewed. Because cyclosporine can affect the immune system, it should be handled by caregivers with gloves. Cyclosporine can take several months to work and needs frequent blood test monitoring.
Side Effects
The most common and potentially serious side effects are high blood pressure and kidney problems. Cyclosporine may also increase the risk of infections; notify your rheumatology provider if you notice signs of an infection, such as a fever or shaking chills.
Other possible side effects include headaches, nausea, vomiting, abdominal pain or indigestion, swelling of the hands or feet, tremors, increased hair growth, gum swelling, muscle cramps, or numbness and tingling of the hands or feet.
Tell Your Rheumatology Provider
Cyclosporine interacts with many medicines; keep your rheumatology provider updated on all medications you are taking. Let your rheumatology provider know if you have high blood pressure, kidney problems, or cancer, as cyclosporine can complicate these conditions.
Before starting cyclosporine, talk with your rheumatology provider about whether you need any additional vaccinations to help prevent infections or if you are pregnant or are considering having a child. Cyclosporine can cause serious birth defects and should not be taken while pregnant, attempting to become pregnant, or while breastfeeding.
While taking cyclosporine, talk with your rheumatology provider before receiving any vaccines or undergoing any surgeries or if you have signs of an infection such as fever or chills, or if you are taking antibiotics.
Updated June 2026 by Elizabeth Graef, DO, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.
This patient fact sheet is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.