Ciclosporin
Aliases: Cyclosporine A · Sandimmun · Neoral
Last verified: 2026-09-23
The short version
A cyclic undecapeptide from a fungus — the immunosuppressant that made organ transplantation possible that made organ transplantation possible; also for psoriasis, rheumatoid arthritis, dry eye.
Identity & type
- Molecular type
- peptide
- Origin
- A cyclic undecapeptide from a fungus — the immunosuppressant that made organ transplantation possible that made organ transplantation possible; also for psoriasis, rheumatoid arthritis, dry eye.
Mechanism of action
Binds cyclophilin → calcineurin inhibition → blocks IL-2 transcription in T cells.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. Transplant 5–15 mg/kg/day; ophthalmic 0.05–0.1% drops.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
Transplant 5–15 mg/kg/day; ophthalmic 0.05–0.1% drops. A transplant standard: prevents organ rejection; patients monitor kidneys and blood pressure, but the life benefit is unquestionable.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
A transplant standard: prevents organ rejection; patients monitor kidneys and blood pressure, but the life benefit is unquestionable.
Protocol — official vs community
Official / label
Transplant immunosuppression: 5–15 mg/kg/day orally divided twice daily (Sandimmun/Neoral), titrated by trough blood levels; non-transplant indications (atopic dermatitis, psoriasis, RA, nephrotic syndrome) use lower doses; ophthalmic 0.05% drops for dry eye.
- 01Titrate by measured trough concentrations to indication-specific target ranges
- 02Neoral (microemulsion) is not bioequivalent to Sandimmun — conversions require re-titration
Duration: Lifelong in transplantation; disease-defined courses in dermatologic and renal indications.
Narrow therapeutic index: nephrotoxicity, hypertension, tremor and hypertrichosis track exposure. Therapeutic drug monitoring is the dosing method, not a safety luxury.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
Decades of clinical use.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Nephrotoxicity, hypertension, hypertrichosis, tremor; narrow window (TDM).characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials