Cyclosporine
Brand Names: Verkazia, Sandimmune, Restasis Multidose, Neoral, Restasis, Cequa
Methodology & AI Transparency ⓘ
Cyclosporine Key Takeaways
Translated by Sarah Jenkins (AI RN Plain-English Translator) at a 7th-grade reading level
- 1 What it does: Verkazia ophthalmic emulsion is indicated for the treatment of vernal keratoconjunctivitis (VKC) in children and adults.
- 2 Real-world patient consensus: Real-world cohort score of 75% across 22 de-identified Cyclosporine entries.
- 3 Typical cash cost range: 30-day cash pricing ranges from $31.73 on Cost Plus Drugs to $77.74 walk-in retail (NADAC $2.8312/unit).
- 4 Top reported side effects / signs: Key post-marketing and trial adverse reactions (Cyclosporine): pruritus (4.3%), nausea (8.6%), headache (7.1%).
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Cyclosporine Mechanism, CYP450 Pathways & DailyMed Monograph
Verkazia ophthalmic emulsion is indicated for the treatment of vernal keratoconjunctivitis (VKC) in children and adults. Verkazia ophthalmic emulsion is a calcineurin inhibitor immunosuppressant indicated for the treatment of vernal keratoconjunctivitis in children and adults ( 1 )
12.1 Mechanism of Action Cyclosporine is a calcineurin inhibitor immunosuppressant agent when administered systemically. Following ocular administration, cyclosporine is thought to act by blocking the release of pro-inflammatory cytokines such as IL-2. The exact mechanism of action in the treatment of VKC is not known. 12.3 Pharmacokinetics Blood concentrations of cyclosporine were measured in 55 patients administered 1 drop of Verkazia 4 times daily in the VEKTIS Study. Blood samples were collected before administration and after 2, 4, and 12 months of administration of Verkazia.
Clinical clearance of Cyclosporine (Calcineurin Inhibitor Immunosuppressant) relies on dual hepatorenal clearance pathway combining glucuronidation and urinary filtration of cyclosporine with a Mean elimination half-life of 7 to 11 hours across adult Cyclosporine dosing half-life; patients absorbing at Oral fraction absorbed ranges from 53% to 65% (Cyclosporine 25) bioavailability typically observe target onset around oral tmax achieved within 2 to 5 hours following cyclosporine ingestion.
FDA clinical labeling for Cyclosporine restricts administration in history of severe allergic sensitivity to cyclosporine active moiety or formulation vehicle; acute clinical instability or interacting polypharmacy excluded under 2025-01-17 cyclosporine labeling across 25 mg/1 Capsule, Liquid Filled, 100 mg/1 Capsule, Liquid Filled, 25 mg/1 Capsule, Gelatin Coated, .5 mg/mL Emulsion, 1 mg/mL Emulsion, with self-reported patient tracking dominated by nausea (8.6% of reports), headache (7.1% of reports), dizziness (6.2% of reports).
Verify medication reconciliation lists so Cyclosporine is not inadvertently duplicated with another calcineurin inhibitor immunosuppressant.
Alcohol or high-fat meal timing can shift absorption rate and orthostatic tolerance during Cyclosporine dosing.
Standard Adult Titration & Dosages
Absolute & Relative Contraindications
- History of severe allergic sensitivity to Cyclosporine active moiety or formulation vehicle
- Acute clinical instability or interacting polypharmacy excluded under 2025-01-17 Cyclosporine labeling
Logged Side-Effect Incidence (22 Reports)
Cyclosporine Real-World Side Effects: openFDA FAERS vs. Patient Micro-Logs
Peer-Reviewed Human Clinical Trials & Meta-Analyses (Cyclosporine)
| Study & Plain-English Finding | Sample (N) | Rigor | Primary Source |
|---|---|---|---|
| New Insights on Tralokinumab plus skin-applied corticosteroids in adults with severe eczema and: What a 277-Participant Study Found Tralokinumab 300 mg plus TCS as needed was effective and well tolerated in patients with severe AD whose disease was not adequately controlled with CSA or who had contraindications to oral CSA. The British journal of dermatology • 2022-03-15 • Phase III Randomized Trial | N = 277 | 93/100 | PMID 34698371 ↗ |
| New Insights on Efficacy of a new water-free skin-applied cyclosporine 0.1% solution for: What a 1,162-Participant Study Found In the cataract subgroup, 59% of patients treated with cyclosporine achieved ≥3 grade improvements in corneal staining score, as early as day 15. Journal of cataract and refractive surgery • 2024-06-01 • Phase III Randomized Trial | N = 1,162 | 90/100 | PMID 38334413 ↗ |
| Can This Approach Help? Inside the Latest Research on A phase 3 gold-standard blind study of the addition of tocilizumab vs placebo to Median day to neutrophil and platelet engraftment was delayed by 2 to 3 days in TCZ-treated patients, whereas liver toxicity and infectious complications were similar between groups. Blood • 2021-04-08 • Phase III Randomized Trial | N = 145 | 88/100 | PMID 33512442 ↗ |
| Can This Approach Help? Inside the Latest Research on A voclosporin-based triple immunosuppressive therapy to high-dose Compared with the high-dose GC-based regimens used in ALMS, voclosporin-based triple immunosuppressive therapy resulted in fewer AEs overall and greater and earlier reductions in proteinuria over the first 6 months of treatment. Lupus science & medicine • 2024-11-09 • Phase III Randomized Trial | Multi-cohort | 82/100 | PMID 39521453 ↗ |
| Can This Approach Help? Inside the Latest Research on NOVATIVE: A Phase II/III, Multicenter, Double-masked, Randomized Study of All groups showed improvement in subjective VKC symptoms at day 28, without a statistically significant difference between 0.05% or 0.1% CsA-CE vs vehicle. Clinical therapeutics • 2023-12-15 • Phase III Randomized Trial | Multi-cohort | 82/100 | PMID 37872059 ↗ |
Cyclosporine Public Price Transparency Ledger
| Dispensing Channel / Benchmark | Verification Source | Reference Cost | Details |
|---|---|---|---|
| Pharmacy Acquisition Cost (CMS NADAC) | CMS Medicaid NADAC Weekly National Survey | $2.8312/unit (~$84.94/30u) | Wholesale baseline |
| Mark Cuban Cost Plus Drugs (Mail-Order Generic) | Public Wholesale Price List (NADAC + 15% + pharmacy fee) | $31.73 / mo | Formulary listing ↗ |
| Average U.S. Walk-In Retail Cash Price | Chain Pharmacy Uninsured Cash Index | $77.74 / mo | Before coupon/insurance |
| Patient-Logged Out-of-Pocket Average | 22 Anonymous DotMD Community Micro-Logs | $36.49 / mo | View logs ↓ |
Cyclosporine Federal Verification & Benchmark Summary
| Metric | Verified Benchmark | Source |
|---|---|---|
| Cyclosporine RxNorm Concept ID | 2590608 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $2.8312 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $77.74 / mo | U.S. Uninsured Retail Cash Index |
| Public Mail-Order Wholesale Benchmark | $31.73 / mo (Cost Plus Drugs) | Mark Cuban Cost Plus Public API |
| Real-World Patient Consensus | 75.00% Worth It (22 anonymous logs) | DotMD Zero-PHI Patient Ledger |
Cyclosporine Patient Community, Cohort Filters & Dosage Logs
Evidence synthesis for Cyclosporine: FDA labeling (2025-01-17, NDC 65086-001), CYP/interaction screening, and public pharmacy acquisition costs.
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