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Patient's Guide to Heart Transplant Surgery

Cyclosporine A (Sandimmune) (Neoral)

About 6 mg per kilogram of body weight a day, initially, then changing dosage according to your blood levels. For best absorption by the stomach, take cyclosporine before meals. Capsules come in 100 mg and 25 mg.

An immunosuppressive drug which is believed to work by blocking the action of the immune cells in your blood known as the T-lymphocytes. These immune cells normally take part in the rejection process.

Side Effects
Chills, fever, rash, increased hair growth (hirsutism), impaired kidney function, high blood pressure, soft tissue tumors, burning pain in feet and hands, and hand tremors. Because cyclosporine is supplied in an olive oil base, you may have temporary episodes of diarrhea, but this is usually mild.

Most patients need some medications for high blood pressure caused by cyclosporine. This will be adjusted by the doctors on an individual basis.

Increase hair growth is a temporary side effect of cyclosporine. Although bald patients appreciate the new hair growth, women are not so appreciative. Excessive facial hair can be removed easily by the use of depilatories such as Surgi-Cream or other facial hair removers. Some cosmetic manufacturers, such as Merle Norman or Revlon, produce special facial hair removers. Products designed to remove body hair from legs and underarms, such as Neet or Nair, should not be used on your face. Before using any depilatory, do a patch test on your hand to check for an allergic reaction. Once the patch test is completed, wait 24 hours to evaluate the skin on your hand. If there is no reaction (like redness, itching, or swelling) you can assume you are not allergic and use the product. You may also undergo waxing to remove excessive hair.

Getting the right medication dose of Cyclosporine/FK506 (Prograf) level for you
While you are in the hospital, your medication levels will be drawn daily for some time after transplant. You must wait to take your morning dose of medication until after the blood level has been drawn. The reason for this careful planning is that we want to know the lowest level of medication in your blood during a 24-HOUR PERIOD. This lowest level, or "trough" blood level, occurs just before you take your next dose of medication. Based on the trough levels of medication in your blood, we will either raise, lower or keep the same medication dosage.

We may also vary the number of times you will be taking your Cyclosporine or Prograf during a 24-hour period. Once your blood has been drawn, you may take your morning dose of Cyclosporine/Prograf.



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