Ciclosporin is usually an ‘add on’ treatment to supplement the main DMARD or to enable the reduction of regular steroid treatment. It is one of the least commonly prescribed RA drugs.  


Ciclosporin is now only used rarely since the continuing development of more effective targeted treatments.

Ciclosporin is also used to minimise the possibility of rejection of transplanted organs as well as for other inflammatory conditions.  

It is accepted practice that ciclosporin is only prescribed by the manufacturer’s trade name of ‘Neoral’ as there are slight variations with the responses seen to the same drug produced by other manufacturers.  


Ciclosporin was developed in the 1970s, and its effects on dampening down the immune system have been used for the treatment of rheumatoid arthritis as well as following kidney and heart transplants.  

Most commonly reported side effects  

As with any medication, ciclosporin has a number of possible side effects, although it is important to remember that these are only potential side effects and they may not occur at all.  

Close monitoring with blood tests is important as well as regular blood pressure monitoring, and after 6 months of treatment, kidney function needs to be checked. When Neoral is prescribed together with another drug that affects the immune system, monitoring will be according to which drug has the most frequently required regimen.  

Side effects may include: nausea, vomiting, diarrhoea, swollen gums, raised blood pressure, fever, fatigue, headache and increased risk of infections, but this list is not exhaustive.  

More information on side effects can be found in the patient information leaflet for ciclosporin that comes with your medicine.  

Remember to report any concerns about possible side effects to your doctor, pharmacist or nurse.  

 Ciclosporin with other medicines  

There are some significant potential drug interactions between ciclosporin and many other medicines. It is particularly important that a full and complete medical history is given to the prescribing doctor.  

Remember to take care when using any other medicines or complementary therapies (even if bought ‘over the counter’ for colds, flu or other home remedies). Remember to check with a doctor, pharmacist or nurse that they are safe to take with ciclosporin as well as with any other medication being taken.  

Ciclosporin during pregnancy and breastfeeding  

Neoral should not be used during pregnancy.  

There has been a limited experience of pregnant women taking ciclosporin, but the risk of premature delivery has been described.  

Ciclosporin passes into breast milk; therefore, breastfeeding is not recommended.  

Ciclosporin and immunisations/ vaccinations  

Advice about immunisation or vaccination for anyone taking ciclosporin must be obtained from the prescribing specialist consultant. 

Medicines in rheumatoid arthritis

We believe it is essential that people living with RA understand why certain medicines are used, when they are used and how they work to manage the condition.


Updated: 01/09/2020