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Library · Immune · Prevention of organ transplant rejection

Cyclosporine (Neoral, Sandimmune, Gengraf)

Neoral, Sandimmune, Gengraf, Cyclosporine, CsA, Ciclosporin

Cyclic polypeptide immunosuppressant approved to prevent organ-transplant rejection and treat severe autoimmune diseases like psoriasis and rheumatoid arthritis by blocking calcineurin-driven T-cell activation. Effective for quick disease control but usually limited to 1–2 year courses given nephrotoxicity and hypertension risks; recent work (2020–2025) focuses on rescue-therapy use, side-effect management, and topical delivery to cut systemic exposure.

Research score 95/100. Reference only, not a dose.

Boxed warning: Risk of opportunistic infections

  • Immune Boosting
  • Anti-inflammatory
  • Inflammation Resolution
  • Anti-viral
  • Anti-bacterial
US status
Prescription Only
Approval
FDA + EMA Approved
Evidence
FDA-approved Calcineurin inhibitor. Standard for transplant rejection prophylaxis, severe psoriasis, and rheumatoid arthritis. Ophthalmic drops for dry eye.
Research score
95 / 100
Indication
Multiple Approved Indications
Origin
Switzerland
Source category
Immune System
Status group
Approved / prescription

Mechanism

Forms a complex with cyclophilin that inhibits calcineurin, blocking NFAT activation and nuclear entry, which suppresses IL-2 and other cytokine genes needed for T-cell proliferation; also affects B-cells, dendritic cells, P-glycoprotein expression, and calcium handling.

Safety file

Systemic use risks kidney and liver damage, high blood pressure, and higher infection/cancer risk (skin cancer, lymphoma); ophthalmic use is mostly safe, causing mild burning or stinging.

  • Nephrotoxicity
  • Hypertension
  • Tremor
  • Hirsutism
  • Gingival hyperplasia
  • Increased infection risk
  • Hepatotoxicity