Neoral

Neoral is a brand name for a formulation of cyclosporine, an immunosuppressant drug classified as a calcineurin inhibitor. It is used to prevent organ transplant rejection and to treat certain autoimmune diseases in combination with other medications. Neoral’s micellar or microemulsion formulation was developed to improve oral bioavailability and to provide more consistent blood concentrations than earlier formulations.

The drug works by inhibiting T cell activation, principally by blocking the phosphatase activity of calcineurin, which reduces production of interleukin-2 and other cytokines. Because of its potent immunosuppressive effects, Neoral is typically prescribed and monitored by specialists, with dosing individualized to achieve target trough levels and minimize toxicity.

Common indications include prevention of rejection in kidney, liver, and heart transplantation, as well as treatment of severe psoriasis, psoriatic arthritis, and rheumatoid arthritis in some patients. It may also be used for other autoimmune or inflammatory conditions under expert care. Neoral is taken orally as capsules or an oral solution; the exact dose depends on the indication, body weight, and drug level monitoring. It is a substrate of cytochrome P450 3A4 and P-glycoprotein, so many drug interactions can significantly alter exposure. Food can affect absorption, and Neoral requires careful adherence and regular laboratory monitoring.

Adverse effects can include nephrotoxicity, hypertension, hyperkalemia, tremor, hirsutism, gum overgrowth, and increased infection or malignancy risk due to immunosuppression. Contraindications include certain hepatic dysfunctions and hypersensitivity to ciclosporin. Pregnancy carries substantial risk and must be considered carefully with medical guidance.