Product image of Neoral (Ciclosporin) supplied by GNH India

Neoral

Active Ingredient:
Ciclosporin
Origin:
EU

Neoral (Ciclosporin)

Ciclosporin, the active ingredient in Neoral, is a calcineurin inhibitor presented as a 100 mg/mL oral solution for oral use. It treats organ transplant rejection, psoriasis, rheumatoid arthritis and severe atopic dermatitis in appropriate patients.

GNH India supplies Neoral as a licensed, GDP-compliant international pharmaceutical supplier serving hospitals, transplant centres, pharmacies and clinics worldwide.

Manufacturer / TM Owner

Novartis Ireland Limited

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Indications & Clinical Uses

Neoral (ciclosporin) is used in conditions where immune modulation is required, particularly in transplant medicine and inflammatory skin or joint disorders.

  • Organ transplant rejection: prevents acute and chronic rejection by suppressing T‑cell activation.
  • Psoriasis: reduces plaque formation and severity by inhibiting inflammatory cytokines.
  • Rheumatoid arthritis: improves joint symptoms and slows disease progression through immune suppression.
  • Severe atopic dermatitis: decreases skin inflammation and pruritus by limiting T‑cell mediated responses.

How It Works

  • Ciclosporin binds to the intracellular protein cyclophilin, forming a complex that inhibits the phosphatase activity of calcineurin. This blockade prevents dephosphorylation of nuclear factor of activated T‑cells (NF‑AT), thereby reducing transcription of interleukin‑2 and other cytokines essential for T‑cell activation and proliferation. The resulting immunosuppressive effect diminishes the immune response involved in graft rejection and inflammatory diseases.

Side Effects

Neoral may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

  • Tremor: mild shaking of hands or limbs.
  • Hypertension: elevated blood pressure.
  • Hyperlipidaemia: increased cholesterol or triglycerides.
  • Nausea: upset stomach or vomiting.

Serious or Rare Side Effects

  • Nephrotoxicity: impaired kidney function.
  • Hepatotoxicity: liver enzyme elevation or injury.
  • Infections: heightened susceptibility to bacterial, viral or fungal infections.
  • Malignancy risk: possible increased risk of lymphomas or skin cancers.

Precautions & Warnings

Before initiating therapy with Neoral, several safety considerations should be observed.

  • Renal function monitoring: assess serum creatinine and glomerular filtration rate regularly.
  • Blood pressure control: monitor and treat hypertension during therapy.
  • Lipid profile assessment: check cholesterol and triglyceride levels periodically.
  • Drug interactions: review concomitant medications for potential cyclosporine interactions.
  • Pregnancy and lactation: avoid use unless benefits outweigh risks; consult specialist.
  • Store at ambient temperature: keep below 25 °C, retain in original container, protect from moisture and light.

Avoid Interactions

Neoral interacts with several medicines that can alter its concentration or toxicity.

Major Interactions (Avoid)

  • Ketoconazole and other azole antifungals: markedly increase cyclosporine blood concentrations, raising toxicity risk.
  • Rifampicin: significantly reduces cyclosporine levels, potentially leading to graft rejection.
  • St. John’s wort: induces metabolism and lowers cyclosporine exposure, compromising efficacy.

Moderate Interactions (Monitor Closely)

  • NSAIDs: may add to nephrotoxic potential; monitor renal function.
  • Statins (especially simvastatin): increased risk of myopathy; consider dose adjustment.

Frequently Asked Questions

Neoral contains ciclosporin and is prescribed to prevent organ transplant rejection and to manage chronic inflammatory conditions such as psoriasis, rheumatoid arthritis and severe atopic dermatitis. It works by suppressing the immune system, helping to reduce tissue damage caused by overactive immune responses.

Ciclosporin binds to cyclophilin inside immune cells, forming a complex that blocks calcineurin. This inhibition prevents activation of nuclear factor of activated T‑cells (NF‑AT), leading to reduced interleukin‑2 production and diminished T‑cell activation, which collectively dampen the immune response.

The dose of Neoral is individualized and set by the prescribing clinician based on the specific indication, patient weight, renal function and other clinical factors. Healthcare providers determine the appropriate concentration and volume to be administered for each patient.

Ciclosporin’s pregnancy category is listed as unknown, and safety data are limited. It is generally avoided during pregnancy and lactation unless the potential benefit justifies the risk. Women who are pregnant, planning pregnancy, or breastfeeding should discuss alternatives with their specialist.

To request Neoral, submit an enquiry on the product page at gnhindia.com indicating the required quantity. GNH India works with hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details and any necessary import documentation.

The primary alternative to ciclosporin is tacrolimus, another calcineurin inhibitor. Both suppress T‑cell activation, but tacrolimus is often considered more potent with a different side‑effect profile, including a higher incidence of neurotoxicity and lower risk of gingival hyperplasia. Choice depends on clinical response, tolerability and physician preference.

Neoral oral solution should be stored at ambient temperature, preferably below 25 °C. Keep the container tightly closed, protect it from moisture and direct sunlight, and retain it in the original packaging until use to maintain stability.

Neoral is taken orally as a measured liquid dose. The prescribed volume is usually drawn with a calibrated syringe or dosing cup and swallowed, often with food to improve tolerability. Patients should follow the exact dosing instructions provided by their healthcare professional.

The most serious adverse effects include nephrotoxicity (kidney impairment), hepatotoxicity (liver injury), severe infections due to immunosuppression, and an increased risk of certain malignancies such as lymphomas or skin cancers. Regular laboratory monitoring and clinical assessment are essential to detect these complications early.

Neoral is contraindicated in individuals with known hypersensitivity to ciclosporin or any of its excipients, uncontrolled infections, severe uncontrolled hypertension, and severe renal impairment. Caution is also advised for patients with liver disease or those receiving other nephrotoxic agents.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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