The 5 main things I learnt about Cyclosporine in 2016

My experiences with Cyclosporin 2016

At the end of 2015 I reached my lowest point with my battle with MG thus far. I agreed to my Neurologists recommendation that I start a new immunueosupressent, Cyclosporin.

In South Africa, it is dispensed through Novartis, under the trade name Neural. It is recommended for MG warriors that have severe and resistant MG. 1 

Here are the five most important facts I have learned over the regarding Cyclosporin over the last year. 

1) It takes time to start working

Once I started Cyclosporin, I did not feel an immediate change. After approximately two months I started to feel some positive spin-offs. I was no longer struggling to swallow and I was strong enough to walk short distances with a cane. After 4 months I felt strong enough start driving short distances and walking independently. Every week since, I could feel my strength improving. I still have flares and bad days, but with pacing, lifestyle changes and rest, Cyclosporin has changed my life, little by little. 

2) Keep your kidney function in check 2 

Regular blood tests are required to ensure good kidney function.  Cyclosporin does not normally cause permanent, generally kidney damage. Due to vasoconstriction (restriction of blood flow), kidney function can decrease. However, no relevant changes in tubular function occur. Your doctor will measure your kidney function before you start and periodically throughout your treatment.  

3) Interactions due to everyday items in your kitchen 

Avoid Grapefruit in any form!3 
A drug interaction exists between cyclosporine and grapefruit juice. This is noted to  likely take place at the level of intestinal drug absorption.
Grapefruit juice increases the bioavailability of Cyclosporin, therefore it increases the rate at which it is absorbed. When it is absorbed too quickly it is not as effective as it needs to be. 

Avoid St. Johns Wort 
This over the counter drug used to help reduces anxiety, however, it has shown to decrease Cyclosporin  levels. 

4) How to take it. 4 

Prepare yourself to swallow a HUGE tablet. 
My husband asked at one stage, 'Are you sure that those aren't suppositories?'. Cyclosporin is by far the biggest tablet I have had to swallow. It is not recommended to be crushed. It needs to be taken at the same time daily as to maintain a consistent level in your blood stream. 
Keep them stored in their packaging, which to me looks like a metal air pocket. I use a pair of scissors or helpful husband to open them as I struggle to press them out with my thumb. 

5) Future plans 

You can fall pregnant, but not breastfeed 5 
Cyclosporine is listed as a category C medication, therefore risk cannot be ruled out. It can cause premature birth and low birth weight. Cyclosporin passes into breast milk and therefore breastfeeding is not recommended.



  1. Wow, those pills are huge! I would have a hard time swallowing them I think.

  2. Cyclosporin A is a cyclic undecapeptide from an extract of soil fungi. It is a powerful immunosupressant with a specific action on T-lymphocytes. It can bind to the cyclophilin and then inhibits calcineurin. Thus, it is widely used in organ transplantation to prevent rejection. Cyclosporin A


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