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Brand names: Neoral / Sandimmune / Gengraf • Drug class: Calcineurin inhibitor (immunosuppressant)
Cyclosporine is the original calcineurin inhibitor — the drug that made modern transplantation possible (Nobel Prize in Medicine, 1990). It is still used in kidney transplant and as a steroid-sparing agent in nephrotic syndrome, though tacrolimus has largely replaced it as first-line.
Cyclosporine prevents rejection by blocking T-cell activation — but it commonly raises blood pressure and can injure the kidney at high levels, which is why trough levels are monitored. In FSGS and membranous nephropathy it is used at lower doses as a steroid-sparing treatment.
Cyclosporine established calcineurin inhibition as the foundation of transplant immunosuppression
Cyclosporine trials, 1980s
Effective steroid-sparing agent in nephrotic syndrome (FSGS, membranous nephropathy)
KDIGO glomerular disease guidance, 2021
Hypertension and nephrotoxicity are the main long-term costs — level monitoring is standard
Calcineurin toxicity literature, 1990s-present
Dosed by trough levels (typically 100-250 ng/mL in transplant depending on time post-transplant). Kidney function is monitored closely because the drug itself can injure kidneys at high levels.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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