SANDIMMUN 100 MG 50 CAP

Sandimmun is a medication containing cyclosporine A, an immunosuppressive agent used primarily to prevent organ rejection in transplant patients and to treat certain autoimmune disorders. It is available in a solution for injection, typically administered intravenously or intramuscularly.

How It Works

Mechanism of Action

Sandimmun (cyclosporine A) works by:

1. Immunosuppression:
   • Cyclosporine A inhibits the activation of T lymphocytes (a type of white blood cell) by blocking the production of interleukin-2 (IL-2), a cytokine necessary for T cell activation and proliferation. This helps prevent the immune system from attacking transplanted organs or tissues.
2. Selective Inhibition:
   • It selectively suppresses the immune response without broadly affecting other components of the immune system, which helps in minimizing adverse effects.
3. T Cell Activation:
   • By inhibiting calcineurin, Sandimmun prevents the activation of nuclear factor of activated T cells (NFAT), which is crucial for the transcription of IL-2 and other cytokines involved in the immune response.

Side Effects

Common Side Effects

• Headache:
  • Mild to moderate headaches can occur.
• Gastrointestinal Issues:
  • Nausea, vomiting, and diarrhea.
• Increased Hair Growth:
  • Hypertrichosis, or excessive hair growth, may develop.
• Tremors:
  • Fine or coarse tremors, especially in the hands.

Serious Side Effects

• Kidney Toxicity:
  • Nephrotoxicity, which may manifest as elevated blood creatinine levels and reduced kidney function.
• Hypertension:
  • High blood pressure, which may require management.
• Increased Risk of Infections:
  • Due to the suppression of the immune system, patients may be more susceptible to infections.
• Gingival Hyperplasia:
  • Overgrowth of gum tissue.
• Liver Dysfunction:
  • Elevated liver enzymes, hepatitis, or jaundice.
• Cancer Risk:
  • Long-term use increases the risk of certain cancers, including lymphomas and skin cancers.

Indications

Sandimmun is indicated for:

• Prevention of Organ Rejection:
  • Used in combination with other immunosuppressive agents to prevent organ rejection following kidney, liver, heart, or bone marrow transplants.
• Treatment of Autoimmune Diseases:
  • Conditions such as rheumatoid arthritis, psoriasis, and certain nephrotic syndromes.
• Chronic Rejection:
  • Management of chronic rejection in transplant recipients.

Contraindications

Sandimmun should not be used in the following conditions:

• Hypersensitivity:
  • Known hypersensitivity to cyclosporine A or any of its components.
• Active Infections:
  • In patients with active infections, due to the risk of exacerbating the infection.
• Pregnancy:
  • Should be avoided during pregnancy unless absolutely necessary, as it may harm the fetus.
• Severe Renal Impairment:
  • Contraindicated in patients with severe renal impairment or end-stage renal disease.
• Uncontrolled Hypertension:
  • Not recommended for patients with uncontrolled high blood pressure.

Price in Different Countries

Here is a table showing approximate prices for Sandimmun 1 mL (10 ampoules) in various countries, along with references:

Country	Price (Per Pack)	Reference
United States	$1,500 – $2,000	GoodRx
United Kingdom	£1,200 – £1,500	NHS UK
Canada	CAD $1,800 – $2,300	Health Canada
Australia	AUD $2,000 – $2,500	PBS Australia
India	₹90,000 – ₹1,20,000	Medlife

Top 5 Global Brands

1. Sandimmun – Novartis:
   • The original and well-known brand of cyclosporine A.
2. Neoral – Novartis:
   • A modified formulation of cyclosporine A with improved absorption.
3. Gengraf – Abbott:
   • A formulation of cyclosporine A similar to Neoral.
4. Cyclosporine Capsules – Various Manufacturers:
   • Generic versions of cyclosporine A, available under different brand names.
5. Ciclosporin – Various Manufacturers:
   • Various brands providing generic cyclosporine A.