Live vaccines ketoconazole,voroconazole, itraconazole telithromycin, clarithromycin,erythromycin, diltiazem, verapramil, grape fruit juice rifampicin, rifabutin other inhibitors of CYP3A4 cyclosporin, drugs affecting renal function or the multidrug efflux pump P-glycoprotein statins, fibrates

To prevent organ rejection in renal transplant patients

Lynphocyte, abnormal healing, odema, angioedema lymphodema lever , concomittant infections increased risk of opputunistic infections such as TB , sepsis etc. tachycardia g i upset, stomatitis blood dyscrasis thrombocytopenia thromboembolism increased LDH

High immunological eisk Pregnancy, ensure adequate contraception during and for 12 weeks after therapy Lactation

Special Precaution-

Use under specialist supervision

Hepatic impairment Monitor whole blood conc. and renal function

Hyperlipidaemia Skin cancer risk Elderly

Dosage-

Initially 6mg loading dose as soon as possible after transplant,

Then 2mg daily for 2-3 months Individualise treatment to obtain whole blood through levels of 12 to 20 nanogram/ ml given with corticosteroids

Discontinue if cyclosporin cannot be withdrawn

Use contraindicated. Observe caution Pregnancy, ensure adequate contraception during and for 12 weeks after therapy Lactation