Cyclosporine (Sandimmune) Nursing Considerations

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Generic Name


Trade Name



Prevention of rejection in transplantation, treatment of severe RA, management
of ulcerative colitis


Inhibits normal immune response primarily by decreasing the activity of T cells

Therapeutic Class

Immunosuppressant, antirheumatics (DMARD)

Pharmacologic Class

Polypeptides (cyclic)

Nursing Considerations

• May cause seizures, tremors, hypertension, hepatotoxicity, diarrhea, N/V,
gingival hyperplasia
• Increases immune suppression with corticosteroids
• Avoid grapefruit juice while taking this medications
• Assess for signs of organ rejection
• Monitor renal panel, liver enzymes
• Take medication as directed
• Lifelong therapy required for transplant patients
• Instruct pt on how to take blood pressure

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Hey guys, let’s talk about cyclosporine, also known as Sandimmune. This is an oral medication, but it also comes as drops, and as an IV. Here, you can see the drop form. So when we talk about the therapeutic class versus the pharmacologic class, the therapeutic class is what the drug does in the body while the pharmacologic class is the chemical effect. So the therapeutic class of cyclosporine is an immunosuppressant and antirheumatics and the pharmacologic is a polypeptide. So how does cyclosporine work? Well, it works by inhibiting the normal immune response by primarily decreasing T-cell activity. So we use this medication for the prevention of rejection in transplantation, the treatment of severe rheumatoid arthritis, and the management of ulcerative colitis. So what side effects do we see with this medication? So some common side effects include tremors, also diarrhea, nausea, and vomiting.
So let’s take a look at a few nursing considerations for cyclosporine. With cyclosporine, if your patient is on this medication for the prevention of organ rejection, you’ll want to assess for signs of rejection. Cyclosporine may cause seizures, hypertension, hepatotoxicity, and gingival hyperplasia, which is the overgrowth of the gums. Monitor the patient’s renal panel and liver enzymes. Cyclosporine can increase immune suppression with corticosteroids, so keep that in mind. Teach the patient to take as directed, and instruct on how to take their own blood pressure. They should avoid grapefruit juice on this medication. And if they are a transplant patient, you must stress that this is a lifelong medication for them. So guys, even though this medication is often used for transplants, including kidney transplants, it can cause damage to the kidneys. So if a patient is taking this medication for another reason and they already have kidney disease, cyclosporine would not be an appropriate medication. So that’s it for cyclosporine or Sandimmune. Now go out and be your best self today. And as always happy nursing.

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