What is Sandimmune?Sandimmune is given after organ transplant surgery to help prevent rejection of the organ (kidney, heart, or liver). It is also used to avoid long-term organ rejection in people previously treated with other immunosuppressant drugs. Sandimmune is always used in combination with corticosteroids.
What is the most important information I should know about Sandimmune?While you are taking Sandimmune, constant monitoring is necessary to prevent toxicity due to overdosing or to prevent possible organ rejection due to underdosing. You may need to take Sandimmune orally for an indefinite period following surgery.
High-dose Sandimmune is toxic to the liver and kidneys and may cause serious kidney damage. This toxicity has symptoms similar to those of transplant rejection; you must be monitored closely.
When your immune system is suppressed by Sandimmune, you are at increased risk of infection and certain malignancies, including cancers of the skin and lymph system.
Patients taking Sandimmune may experience brain disorders, convulsions, loss of movement, vision problems, impaired consciousness, and psychiatric disturbances. The chance of convulsions is greater if you are taking high doses of steroid drugs, particularly methylprednisolone. Brain disorders usually go away once Sandimmune is discontinued.
Who should not take Sandimmune?Do not take these products if you have ever had an allergic reaction to them. Avoid Sandimmune by injection if you have ever had an allergic reaction to an injection of the drug or you are sensitive to castor oil (Cremophor EL).
What should I tell my doctor before I take the first dose of Sandimmune?Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Sandimmune. Also, talk to your doctor about your complete medical history, especially if you have liver disease, kidney disease, cancer; high blood pressure, a viral, bacterial, or fungal infection, or any other serious or chronic medical condition.
What is the usual dosage?The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.
Adults: Your doctor will tailor your dosage of Sandimmune in accordance with your body's response. Expect a single dose of 15 milligrams (mg) per 2.2 pounds of body weight 4 to 12 hours before a transplant and the same dose continued daily for 1 to 2 weeks after the operation. After that, the doctor may keep you on a daily dose of 5 to 10 mg per 2.2 pounds of body weight.
Children: The dosage is generally the same for children as for adults, although higher doses are sometimes needed. Sandimmune has been used to prevent transplant rejection in small children.
How should I take Sandimmune?Take the Sandimmune capsule or oral liquid at the same time every day, either with a meal or between meals. You may mix the oral liquid with room-temperature milk, chocolate milk, or orange juice. Use the same beverage as often as possible.
Maintain good dental hygiene and see your dentist frequently for cleanings to prevent tenderness, bleeding, and gum enlargement.
After you use the dosage syringe to transfer the oral solution to a glass, dry the outside of the syringe with a clean towel. Do not rinse or wash it. If you do have to clean it, make sure it is thoroughly dry before you use it again.
You may notice an odor when you open the capsule container; this is normal and will soon dissipate.
What should I avoid while taking Sandimmune?Do not use oral contraceptives without your doctor's approval. Use a barrier method of contraception, such as diaphragms or condoms, during Sandimmune therapy.
Do not consume grapefruit or grapefruit juice during treatment with Sandimmune unless specifically directed to by your doctor.
Avoid getting immunized while you are taking Sandimmune. The drug may make vaccinations less effective or increase your risk of contracting an illness from a live vaccine.
What are possible food and drug interactions associated with Sandimmune?If Sandimmune is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Sandimmune with the following: amiodarone, antibiotics, antiepileptic drugs, antifungal drugs, antitubercular drugs, antivirals, barbiturates, bromocriptine, cholesterol-lowering drugs (such as atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin), calcium-blocking heart and blood pressure medications, cancer drugs (such as melphalan, methotrexate, and tacrolimus), corticosteroids, danazol, Diclofenac, digoxin, gout medications, grapefruit juice, metoclopramide, nonsteroidal anti-inflammatory drugs (NSAIDs), octreotide, orlistat, potassium-sparing diuretics, H2 blockers (such as cimetidine and ranitidine), St. John's wort, trimethoprim/sulfamethoxazole
What are the possible side effects of Sandimmune?Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.
Side effects may include: abdominal discomfort, acne, breathing difficulty, convulsions, coughing, cramps, diarrhea, flulike symptoms, flushing, gum problems, headache, high blood pressure, increased bodily hair growth, kidney problems, liver damage, lymph system tumor, muscle, bone, or joint pain, nasal inflammation, nausea, numbness or tingling, sinus inflammation, tremor, vomiting, wheezing
Can I receive Sandimmune if I am pregnant or breastfeeding?The effects of Sandimmune during pregnancy are unknown. Tell your doctor immediately if you are pregnant, or plan to become pregnant. Sandimmune appears in breast milk and should not be used during breastfeeding. Talk to your doctor about stopping breastfeeding while you are taking Sandimmune.
What should I do if I miss a dose of Sandimmune?If fewer than 12 hours have passed from when you should have taken the dose, take it as soon as you remember. If it is almost time for the next dose, skip the one you missed and resume your regular schedule. Do not take 2 doses at once.
How should I store Sandimmune?Store both the capsules and the oral solution at room temperature. Do not store the liquid in the refrigerator. Keep the liquid from freezing. Sandimmune liquid, once opened, must be used within 2 months.