Neoral

Warning!

- Neoral capsules should be swallowed whole with a mouthful of water. Neoral oral solution doses should be diluted immediately before taking with water, or orange juice/squash or apple juice to improve the taste. Stir the mixture well and drink at once. Neoral oral solution should never be diluted with grapefruit juice. In addition, you should not eat grapefruit or drink grapefruit juice in the hour before taking your dose of Neoral capsules or Neoral oral solution, as this can interfere with the medicine.
- The measuring device for Neoral oral solution should not be allowed to come into contact with the liquid you use to dilute your dose. The measuring device should not be rinsed with water, alcohol or any other liquid. If it is necessary to clean it, the outside should be wiped with a dry tissue.
- This medicine can cause the amount of potassium in your bloodstream to increase. For this reason you should avoid consuming large amounts of foods that have a high potassium content, for example dried fruit, bananas, tomatoes and 'low sodium' salt, while you are taking the medicine. You should also avoid potassium supplements.
- It is important that you have regular blood tests to monitor your kidney and liver function and the level of potassium and lipids in your blood while you are taking this medicine.
- This medicine increases your susceptibility to infections because the suppressed immune system is less able to fight them. For this reason, consult your doctor immediately if you develop a sore throat, any infections, or begin to feel generally unwell.
- Individuals having long term or intense immunosuppressive treatment are at increased risk of developing lymphomas and other cancers, particularly skin cancer. To reduce the risk of skin cancer you should minimise your exposure to strong sunlight and UV light by wearing protective clothing and using a sunscreen with a high protection factor. Discuss this with your doctor.
- Your blood pressure should be regularly monitored while you are taking this medicine. If your blood pressure rises too high you may be prescribed a medicine to lower it.
- If you are taking this medicine for psoriasis you should not receive light treatment, such as PUVA, or other UV light treatment, while taking this medicine. You should also avoid sun beds and excessive unprotected sun exposure.

Use with caution in

- Children
- Elderly people
- Decreased kidney function
- High blood uric acid level (hyperuricaemia)
- Dermatitis patients with skin infections
- Dermatitis and psoriasis patients with malignant or pre-malignant skin conditions

Not to be used in

- Nephrotic syndrome patients with uncontrolled high blood pressure, uncontrolled infections, or any kind of malignancy
- Dermatitis patients under 16 years of age
- Psoriasis and dermatitis patients with abnormal kidney function, uncontrolled high blood pressure, uncontrolled infections or any kind of malignancy (except of the skin)
- Rheumatoid arthritis patients under 18 years of age
- Rheumatoid arthritis patients with abnormal kidney function, uncontrolled high blood pressure, uncontrolled infections, or any kind of malignancy

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.
- This medicine passes into breast milk and women taking this medicine should therefore not breastfeed. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Shaking, usually of the hands (tremor)
- Headache
- Increase in the level of fats eg cholesterol in the blood (hyperlipidaemia)
- Decreased kidney function
- High blood pressure (hypertension)
- Pins and needles (paraesthesia)
- Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain
- Loss of appetite
- Swollen gums
- Fatigue
- High blood potassium level (hyperkalaemia)
- High blood uric acid level (hyperuricaemia) which can cause kidney problems and gout
- Low magnesium level in the blood
- Increased susceptibility to infections
- Disturbances of liver function
- Increased body hair
- Rash
- Muscle cramps
- Weight gain

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.