Key points about ciclosporin

  • Ciclosporin is used to treat inflammatory conditions such as inflammatory arthritis, ulcerative colitis, dermatitis and psoriasis.
  • Ciclosporin is also called Neoral.
  • Find out how to take it safely and possible side effects.
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Ciclosporin is an immunosuppressive medicine which means it interrupts the activity of your immune system, slowing the disease and reducing inflammation. It's used to treat inflammatory conditions such as inflammatory arthritis, ulcerative colitisdermatitis and psoriasis.

Ciclosporin is also used with other medicines to prevent organ transplant rejection.

In Aotearoa New Zealand ciclosporin is available as an injection, capsules and a liquid solution. The information on this page is mainly about ciclosporin capsules.

  • Ciclosporin capsules come in different strengths 25mg, 50mg and 100mg. 
  • The dose you have will depend on:
    • how much you weigh
    • what condition is being treated
    • how well the medicine works for you
    • whether you have any side effects from this medicine.
  • Your dose may be changed from time to time.
  • Always take ciclosporin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
  • Read what to do if you think a child or someone else has taken a medicine that's not for them.

  • Timing: Take your dose twice a day. It's best to take the doses 12 hours apart, eg, 8am and 8pm. Take your dose at about the same time each day.
  • You can take ciclosporin with or without food. Avoid having large amounts of grapefruit or grapefruit juice as it can change the levels of ciclosporin in your body.
  • Swallow your capsules whole with a full glass of water: Don't open or chew them.
  • Avoid or limit alcohol: Avoid heavy or binge drinking because it can increase your risk of side effects, such as problems with your liver. 
  • Missed dose: If you forget to take your dose, take it as soon as you remember. But if it is nearly time for your next dose, take the next dose at the right time. Don't take extra doses to make up for a forgotten dose. If you're not sure what to do, ask your healthcare provider.
  • Keep taking ciclosporin regularly: Ciclosporin doesn't work straight away. It usually takes a few weeks before you notice the full benefits. If you stop ciclosporin treatment for more than a few weeks there's a risk your condition may worsen.

Here are some things to know when you're taking ciclosporin. Other things may be important as well, so ask your healthcare provider what you should know about.

Protect yourself from too much sunlight

Ciclosporin can make you more sensitive to the sun and your skin is more likely to burn.

  • Avoid direct sun exposure. When outside, protect your skin by using an oil-free sunscreen.
  • Apply the sunscreen to all areas especially your face, neck and ears. Read more about using sunscreen.
  • Wear clothing that protects you from the sun. Wear sunglasses and a hat when outdoors.

Taking other medicines and supplements

Ciclosporin can interact with some medicines, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting ciclosporin and before starting any new products.

You may need regular blood tests

While you're taking ciclosporin you'll need to have regular blood tests to check the treatment is working and to monitor for side effects. 

Get the flu vaccine every year

Keep your flu vaccination up to date to reduce your risk of getting the flu. It's safe for you to have the annual flu vaccine. Some vaccines should not be taken if you are taking ciclosporin. Always check with your healthcare provider first.

Tell your healthcare providers

Make sure you tell anyone providing you with health, dental or medical care that you are taking ciclosporin.

Pregnancy and breastfeeding

It's not advisable to get pregnant while taking ciclosporin. If you plan to become pregnant, or find you are pregnant, talk to your doctor. Tell your doctor if you are breastfeeding.

Like all medicines, ciclosporin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Feeling sick (nausea) 
  • Vomiting (being sick)
  • Diarrhoea (runny poo)
  • Stomach pain
  • Take your dose with food.
  • Tell your doctor if they bother you.

  • Increase and darkening of body hair
  • Ciclosporin can cause an increase and darkening of body hair especially on the face.
  • This can be managed with bleaching or other cosmetic approaches.
  • Tell your doctor if this bothers you.
  • Bleeding, tender or enlarged gums
  • Practice good dental hygiene – brush and floss regularly, and visit your dentist regularly.
  • Tell your dentist you are taking ciclosporin
  • A feeling of pins and needles or a burning feeling in the hands and feet
  • Slight tremor of the hands
  • This usually happens when you first start treatment but lessens after a few weeks and is not serious.  
  • Increase in blood pressure
  • Ciclosporin can affect your kidneys and may increase blood pressure.
  • This is more common in older people.
  • Your healthcare provider will monitor your kidneys and blood pressure  regularly. 
  • Your doctor may advise to reduce the dose or stop the medicine if necessary. 
  • Tiredness or dizziness
  • Muscle cramps
  • Flushing
  • Acne
  • Tell your doctor if this bothers you.
  • Signs of changes in your blood cells, such as a sore mouth, sore throat, mouth ulcers, easy bruising, nosebleeds, bleeding gums, shortness of breath, fever or infection
  • Changes in your blood cells are rare but serious.
  • Tell your doctor immediately or phone Healthline on 0800 611 116.
  • Signs of problems with your liver, such as sudden pains in your stomach, loss of appetite or yellowing of your skin and eyes
  • Liver problems are rare but serious.  
  • Tell your doctor immediately or phone Healthline on 0800 611 116.

Read more about medicines and side effects and reporting a reaction that you think might be a side effect.

The following links have more information on ciclosporin. Be aware that websites from other countries may contain information that differs from New Zealand recommendations:

NZ Formulary Patient Information

Australian Rheumatology Association Ciclosporin(external link) 


  1. Ciclosporin(external link) NZ Formulary, NZ

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Credits: Sandra Ponen, Pharmacist, Healthify He Puna Waiora. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Angela Lambie, Pharmacist, Auckland

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