Imural 100mg (Capsule)
Manufactured by: Techno Drugs Ltd.
Cyclosporine Similar medicine
Imural is indicated for
- Ulcerative colitis
- Rheumatoid arthritis
- Psoriasis
- Missed abortion
- Nephrotic syndrome
- Urticaria
- Bone marrow transplantation
- Organ transplantation
- atopic dermatitis
Precautions and warnings
Cyclosporine can increase the risk of developing cancers, especially skin cancer and lymphoma. Because of this, patients should avoid too much exposure to sunlight or ultraviolet (UV) light. Taking cyclosporine also makes it easier to get bacterial, fungal, parasitic, or viral infections, so special care and preventive strategies are needed during long-term use.
During the first few weeks of treatment, cyclosporine may cause temporary increases in blood levels of creatinine and urea, but these usually improve if the dose is lowered. Older patients need especially close monitoring of their kidney function. Blood pressure should also be checked regularly; if high blood pressure develops, it should be treated appropriately.
Cyclosporine can raise potassium levels in the blood, particularly in people who already have kidney problems. Extra caution is necessary if cyclosporine is taken with other drugs that increase potassium. It can also lower magnesium levels, so magnesium supplements might be needed.
Be careful when giving cyclosporine to patients with high uric acid levels. Vaccines may not work as well during treatment, and live vaccines should not be used.
Cyclosporine should not be given to non-transplant patients who have kidney problems, uncontrolled high blood pressure, ongoing infections, or cancer. Regular monitoring of blood pressure, kidney and liver function, and blood electrolytes (such as potassium and magnesium) is required, and doctors should be cautious in people with liver or kidney issues, high uric acid, a history of allergies or anaphylaxis, or those who are pregnant.
Side-effects
- Hypertension; hepatoxicity; tremor; paraesthesia
- hypertrichosis
- facial oedema
- acne; gingival hypertrophy; hyperkalaemia
- fluid retention; increased susceptibility to infections; GI symptoms. Potentially Fatal: Nephrotoxicity; convulsions.
Drug Interactions
Certain medications can increase the level of ciclosporin in your body, including diltiazem, doxycycline, erythromycin, ketoconazole, high doses of methylprednisolone, nicardipine, verapamil, and oral contraceptives. On the other hand, drugs such as carbamazepine, isoniazid, phenobarbitone, phenytoin, and rifampicin can lower ciclosporin levels. Using high-dose methylprednisolone together with ciclosporin may raise the risk of seizures.
Warning: Taking ciclosporin with specific medicines—including aminoglycosides, amphotericin B, ciprofloxacin, colchicine, melphalan, co-trimoxazole, or NSAIDs—can seriously increase the risk of kidney damage.
Contraindications
Hypersensitivity; malignant neoplasms; uncontrolled hypertension; psoriasis; lactation.
Mode of actions
Cyclosporine is a powerful medicine that weakens the immune system, especially by affecting helper T-cells. It works by blocking a protein called calcineurin and stopping the production of interleukin-2, which lowers the body’s cell-based immune response.
Dosage & Administration
Oral
Immunosuppression in organ transplantation
Adult: Initially, 10-15 mg/kg/day, starting 4-12 hr before procedure and continued for 1-2 wk; usual maintenance: 2-6 mg/kg/day. Lower doses may be used when combined with other immunosuppressants.
Severe atopic dermatitis
Adult: Initially, 2.5 mg/kg/day, in 2 divided doses. Reduce to lowest effective dose once remission is achieved. Stop treatment if there is no sufficient improvement to max dose within 6 wk. Max: 5 mg/kg/day.
Psoriasis
Adult: Initially, 2.5 mg/kg/day, in 2 divided doses. Reduce to lowest effective dose once remission is achieved. Stop treatment if there is no sufficient improvement to max dose within 6 wk. Max: 5 mg/kg/day.
Rheumatoid arthritis
Adult: 2.5 mg/kg/day, in 2 divided doses. Treatment should continue for 6-8 wk. If response is insufficient, may increase dose gradually. Max: 4 mg/kg/day.
Nephrotic syndrome
Adult: 5 mg/kg daily, given in 2 divided doses.
Child: 6 mg/kg daily, given in 2 divided doses.
Intravenous
Prophylaxis of graft rejection in bone marrow transplantation
Adult: Intially, 3-5 mg/kg/day starting on the day before transplantation and continue for up to 2 wk or until oral therapy can be initiated at a maintenance of 12.5 mg/kg/day. Continue maintenance dose for at least 3-6 mth.
Immunosuppression in organ transplantation
Adult: Initially: 5-6 mg/kg/day as a single dose, infuse dose over 2-6 hr. Switch to an oral dosage form as soon as possible.
Pregnancy & Lactation
Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.
Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.
This medicine passes into breast milk. Talk to your doctor before breastfeeding.
Pack Size & Price
30's pack Price : ৳3750
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