Two medicines, side by side
Cyclosporine vs tacrolimus
Cyclosporine and tacrolimus are both labeled for organ transplant rejection. Drugs@FDA records approvals of cyclosporine since 1983 and of tacrolimus since 1994. Pharmacies paid $1.04 per unit (Cyclosporine 0.05% eye emulsion) and $0.970 per gram (Tacrolimus 0.1% ointment) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like.
Check it at the source: the cyclosporine FDA label on DailyMed (effective August 10, 2026); the tacrolimus FDA label on DailyMed (effective July 17, 2026).
Highlights of the cyclosporine record
Cyclosporine (Restasis) · label of August 10, 2026
Only physicians experienced in management of systemic immunosuppressive therapy for the indicated disease should prescribe Neoral. At doses used in solid organ transplantation, only physicians experienced in immunosuppressive therapy and management of organ transplant recipients should prescribe Neoral. Patients receiving the drug should be managed in facilities equipped and staffed with adequate laboratory and supportive medical resources.
Used for
From the label: indicationsKidney, Liver, and Heart Transplantation Neoral is indicated for the prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants. Neoral has been used in combination with azathioprine and corticosteroids. Rheumatoid Arthritis Neoral is indicated for the treatment of patients with severe active, rheumatoid arthritis where the disease has not adequately responded to methotrexate. […]
On the market
- Earliest approval on file
- November 14, 1983
- Generic labelers
- 14 labelers
- Pharmacy cost
- $1.04 per unit
Supply and safety
- Shortage
- No current entry
- Recalls
- 7
Highlights of the tacrolimus record
Tacrolimus (Prograf) · label of July 17, 2026
MALIGNANCIES AND SERIOUS INFECTIONS Increased risk for developing serious infections and malignancies with Tacrolimus or other immunosuppressants that may lead to hospitalization or death. ( 5.1 , 5.2 ) WARNING: MALIGNANCIES AND SERIOUS INFECTIONS See full prescribing information for complete boxed warning. Increased risk for developing serious infections and malignancies with tacrolimus or other immunosuppressants that may lead to hospitalization or death.
Used for
From the label: indicationsTacrolimus capsules are a calcineurin-inhibitor immunosuppressant indicated for the prophylaxis of organ rejection in adult and pediatric patients receiving allogeneic liver, kidney or heart transplants, in combination with other immunosuppressants. […]
On the market
- Earliest approval on file
- April 8, 1994
- Generic labelers
- 33 labelers
- Pharmacy cost
- $0.970 per gram
Supply and safety
- Shortage
- No current entry
- Recalls
- 9
Source: FDA drug labels via openFDA (Cyclosporine label of August 10, 2026, Tacrolimus label of July 17, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do cyclosporine and tacrolimus differ on the record?
Both are in FDA's class calcineurin inhibitor immunosuppressants.
Half-life, in each label's words: Cyclosporine, “The disposition of cyclosporine from blood is generally biphasic, with a terminal half-life of approximately 8.4 hours …”; Tacrolimus, “Fecal elimination accounted for 92.4±1.0% and the elimination half-life based on radioactivity was 48.1±15.9 hours …”
Both labels carry a boxed warning; the records quote them.
Generics: cyclosporine since 1999; tacrolimus since 2009 (Drugs@FDA).
| Cyclosporine | Tacrolimus | |
|---|---|---|
| Labeled for | Organ transplant rejection, Rheumatoid arthritis | Organ transplant rejection, Eczema (atopic dermatitis) |
| Pharmacologic class | Calcineurin Inhibitor Immunosuppressant | Calcineurin Inhibitor Immunosuppressant |
| How it works (label) | n/a | n/a |
| Half-life (label) | The disposition of cyclosporine from blood is generally biphasic, with a terminal half-life of approximately 8.4 hours (range, 5 to 18 hours). | Fecal elimination accounted for 92.4±1.0% and the elimination half-life based on radioactivity was 48.1±15.9 hours whereas it was 43.5±11.6 hours based on tacrolimus concentrations. |
| Earliest approval on file (Drugs@FDA) | November 14, 1983 | April 8, 1994 |
| First generic approved | October 29, 1999 | August 10, 2009 |
| Generic labelers (NDC) | 14 labelers | 33 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $1.04 per unit (Cyclosporine 0.05% eye emulsion) | $0.970 per gram (Tacrolimus 0.1% ointment) |
| 12-month price change | -49% | +3% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 7 | 9 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 115,545 | 156,020 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
Do their labels mention each other?
Cyclosporine label, drug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Tacrolimus label, drug interactionsDRUG INTERACTIONS Mycophenolic Acid Products: Can increase MPA exposure after crossover from cyclosporine to tacrolimus; monitor for MPA-related adverse reactions and adjust MMF or MPA dose as needed. ( 7.1 ) Nelfinavir and Grapefruit Juice:
Tacrolimus label, drug interactionsMycophenolic Acid Products: Can increase MPA exposure after crossover from cyclosporine to PROGRAF; monitor for MPA-related adverse reactions and adjust MMF or MPA dose as needed.
Source: FDA drug labels via openFDA
What next?
- Alternatives to cyclosporine
- every medicine labeled for the same conditions