Gengraf

 
Generic Name: cyclosporine

Brands: Neoral, Sandimmune

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What is the most important information I should know about Gengraf?

· Notify your doctor immediately if you develop fever or chills, a sore throat, unusual bleeding or bruising, mouth sores, abdominal pain, pale stools, or darkened urine. These symptoms could be early signs of dangerous side effects.

· Tell your doctor and dentist that you are taking this medication before having surgery, before starting any other medicines, and before receiving any vaccinations.

· Although Sandimmune and Neoral are both brands of Gengraf, they do not provide equivalent doses. Do not switch brands of this medication without first talking to your doctor. A dosage adjustment is necessary when you switch brands.

· Do not consume grapefruit or grapefruit juice during treatment with Gengraf unless specifically directed otherwise by your doctor. Gengraf can interact with grapefruit and grapefruit juice and the interaction may have dangerous effects. You should discuss the use of grapefruit and grapefruit juice with your doctor.

 

What is Gengraf?

· Gengraf is an immunosuppressant. Immunosuppressants decrease the effects of your body's immune system.

· Gengraf is used to prevent your body from rejecting a kidney, liver, or heart transplant. Gengraf may be used in combination with another immunosuppressant and a steroid medication. Some brands of Gengraf (e.g. Neoral) are also used to treat severe rheumatoid arthritis and severe psoriasis.

· Gengraf may also be used for purposes other than those listed in this medication guide.

 

What should I discuss with my healthcare provider before taking Gengraf?

· Before taking Gengraf, tell your doctor if you have     ·liver disease;     ·kidney disease;     ·cancer;     ·high blood pressure;     ·a viral, bacterial, or fungal infection;      ·undergone treatment with PUVA, UVB, methotrexate (Rheumatrex, Immunex), coal tar, radiation, or other immunosuppressants; or     ·any other serious or chronic medical condition.

· You may not be able to take Gengraf, or you may require a lower dose or special monitoring if you have any of the conditions listed above.

· Gengraf is in the FDA pregnancy category C. This means that it is not known whether Gengraf will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or become pregnant Dur ring treatment.

· Gengraf passes into breast milk and may harm a nursing infant. Gengraf is not recommended for use during breast-feeding. Do not take Gengraf without first talking to your doctor if you are breast-feeding a baby.

 

How should I take Gengraf?

· Take Gengraf exactly as directed by your doctor. If you do not understand these directions, ask your doctor, nurse, or pharmacist to explain them to you.

· Take each dose with a full glass of water.

· Take Gengraf at the same time(s) each day and in the same relation to meals. For example, take your medication always with a meal, always 1 hour before a meal, or always 1 hour after a meal. Food can alter the amount of Gengraf that gets absorbed into your body, and it is important to keep your routine as consistent as possible.

· The Sandimmune oral solution can be mixed with milk, chocolate milk, or orange juice at room temperature. The Neoral oral solution can be mixed with apple or orange juice at room temperature; it should not be mixed with milk. Do not mix Sandimmune or Neoral with grapefruit juice. To regulate your doses, try to mix your medication with the same beverage as often as possible. Measure the required amount with the syringe provided, then transfer it to the beverage. Use a glass container, not a plastic one, to hold the mixture. Stir well, then drink the mixture immediately. Do not allow it to stand. Put some more of the beverage into the same glass, swirl it around, and drink this too. This process will ensure that you get all of the Gengraf that is prescribed for you.

· To ensure that you get a correct dose, measure the liquid form of Gengraf with the syringe provided. Do not rinse the syringe before or after use. Even the smallest bit of water will alter the dose of Gengraf that you measure, and variations in the dose could become dangerous. If the syringe needs to be rinsed, be sure that it is completely dried before measuring a dose.

· Do not consume grapefruit or grapefruit juice during treatment with Gengraf unless specifically directed otherwise by your doctor. Gengraf can interact with grapefruit and grapefruit juice and the interaction may have dangerous effects. You should discuss the use of grapefruit and grapefruit juice with your doctor.

· Your doctor will probably want you to have regularly scheduled blood tests and other medical evaluations during treatment with Gengraf to monitor progress and side effects.

· Although Sandimmune and Neoral are both brands of Gengraf, they do not provide equivalent doses. Do not switch brands of this medication without first talking to your doctor. A dosage adjustment is necessary when you switch brands.

· Store Gengraf at room temperature away from moisture and heat.

 

What happens if I miss a dose?

· Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the dose you missed, and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. Notify your doctor if you miss a dose of this medication.

 

What happens if I overdose?

· Seek emergency medical attention.

· Symptoms of a Gengraf overdose are not known.

 

What should I avoid while taking Gengraf?

· Do not consume grapefruit or grapefruit juice during treatment with Gengraf unless specifically directed otherwise by your doctor. Gengraf can interact with grapefruit and grapefruit juice and the interaction may have dangerous effects. You should discuss the use of grapefruit and grapefruit juice with your doctor.

· Gengraf can lower the activity of the immune system making you more susceptible to infection. Avoid contact with people who have colds, the flu, or other contagious illnesses. In addition, do not receive vaccines that contain a live strain of the virus (e.g., live oral polio vaccine) and avoid contact with individuals who have recently been vaccinated with a live virus. Notify your doctor at the first sign of fever, chills, or a sore throat

· Tell your doctor and dentist that you are taking this medication before having surgery, before starting any other medicines, and before receiving any vaccinations.

· Although Sandimmune and Neoral are both brands of Gengraf, they do not provide equivalent doses. Do not switch brands of this medication without first talking to your doctor. A dosage adjustment is necessary when you switch brands.

 

What are the possible side effects of Gengraf?

· Notify your doctor immediately if you develop fever or chills, a sore throat, unusual bleeding or bruising, mouth sores, abdominal pain, pale stools, or darkened urine. These symptoms could be early signs of dangerous side effects.

· If you experience any of the following serious side effects, stop taking Gengraf and seek emergency medical attention or contact your doctor immediately:     ·an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);     ·unusual tiredness or weakness;     ·cough or hoarseness, fever, or chills;     ·painful or difficult urination;     ·severe nausea, vomiting, or diarrhea;     ·unusual bleeding or bruising;      ·seizures; or     ·a sudden unusual feeling of discomfort or illness.

· Other, less serious side effects may also occur. Continue to take Gengraf and notify your doctor if you experience     ·tremor (shaking);     ·increased bodily hair growth;     ·gum problems;     ·high blood pressure;     ·numbness or tingling; or     ·decreased appetite.

· Immunosuppressant drugs such as Gengraf increase your risk of certain types of cancer, such as lymphomas or skin cancer. Ask you doctor about the risks and benefits of Gengraf in your treatment.

· Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

 

What other drugs will affect Gengraf?

· There are many drug/drug interactions with Gengraf and you should tell your doctor of any drugs you are on and any new drugs, including herbal products, you start. The interactions could alter Gengraf levels causing a decrease in effectiveness or an increase in side effects. The side effects or effectiveness of the other drugs may also be altered.

· The following are some examples of medicatoins that may result in a drug/drug interaction when taken with Gengraf:     ·trimethoprim with sulfamethoxazole (Bactrim, Septra, Sulfatrim, others), gentamicin (Garamycin, others), and vancomycin (Vancocin);     ·ibuprofen (Advil, Motrin, Nuprin, others), naproxen (Naprosyn, Anaprox, Aleve, others), diclofenac (Voltaren, Cataflam), etodolac (Lodine), flurbiprofen (Ansaid), fenoprofen (Nalfon), indomethacin (Indocin), ketorolac (Toradol), ketoprofen (Orudis KT, Orudis, Oruvail), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin);     ·amphotericin B (Fungizone) and ketoconazole (Nizoral);     ·tacrolimus (Prograf);     ·melphalan (Alkeran);     ·cimetidine (Tagamet, Tagamet HB) and ranitidine (Zantac, Zantac 75);     ·diltiazem (Cardizem, Dilacor XR, Tiazac), nicardipine (Cardene), amiodarone (Cordarone, Pacerone) and verapamil (Calan, Verelan);     ·ketoconazole (Nizoral), itraconazole (Sporanox), and fluconazole (Diflucan);     ·danazol (Danocrine) and methylprednisolone (Medrol, others);     ·erythromycin (Ery-Tab, E-Mycin, E.E.S., P.C.E., others), clarithromycin (Biaxin);     ·bromocriptine (Parlodel);     ·colchicine and allopurinol (Aloprim, Lopurin, Zyloprim);     ·indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), lopinavir-ritonavir(Kaletra) and saquinavir (Fortovase, Invirase);     ·metoclopramide (Reglan);     ·prednisolone (Prelone, Pediapred, others);     ·digoxin (Lanoxin, Lanoxicaps);     ·lovastatin (Mevacor), fluvastatin (Lescol), pravastatin (Pravachol), simvastatin (Zocor), or atorvastatin (Lipitor);     ·PUVA or UVB therapy; and     ·potassium-sparing diuretics (water pills) such as amiloride (Midamor), spironolactone (Aldactone, Spironol), or triamterene (Dyrenium); and     ·any type of vaccination.

 

Where can I get more information?

· Your pharmacist has additional information about Gengraf written for health professionals that you may read.

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