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Prescription medicine

Cyclosporine Brand names: Sandimmune, Neoral, Restasis, Cequa, Verkazia

Cyclosporine (Restasis) is a prescription medicine with an FDA approval on record since 1983. FDA's NDC Directory lists it from 14 generic labelers, and pharmacies paid $1.04 per unit (Cyclosporine 0.05% eye emulsion) in the October 7, 2026 NADAC survey.

  • Generic listed
  • Boxed warning

Check it at the source: the cyclosporine FDA label on DailyMed (effective August 10, 2026, Novartis Pharmaceuticals Corporation); the NDA 50573 record on Drugs@FDA; every cyclosporine label on DailyMed.

Highlights of the record

FDA label of August 10, 2026; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026

Boxed warning

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. The physician responsible for maintenance therapy should have complete information requisite for the follow-up of the patient. Neoral, a systemic immunosuppressant, may increase the susceptibility to infection and the development of neoplasia. In kidney, liver, and heart transplant patients Neoral may be administered with other immunosuppressive agents. Increased susceptibility to infection and the possible development of lymphoma and other neoplasms may result from the increase in the degree of immunosuppression in transplant patients. Neoral Soft Gelatin Capsules (cyclosporine capsules, USP) MODIFIED and Neoral Oral Solution (cyclosporine oral solution, USP) MODIFIED have increased bioavailability in comparison to Sandimmune Soft Gelatin Capsules (cyclosporine capsules, USP) and Sandimmune Oral Solution (cyclosporine oral solution, USP). […]

Used for

From the label: indications and usage

Kidney, Liver, and Heart Transplantation Neoral is indicated for the prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants.

Forms and strengths

  • 25 mg
  • 50 mg
  • 100 mg
  • 0.0009 mg/ml
  • 0.0009 g/ml
  • 0.5 mg/ml
  • 1 mg/ml
  • 50 mg/ml
  • 100 mg/ml

Liquid-filled capsule; emulsion; gelatin-coated capsule; solution/ drops; capsule.

On the market

Earliest approval on file
November 14, 1983 Sandimmune, Novartis; Drugs@FDA’s file, where older or withdrawn approvals can be missing
Generic approvals
24 first October 29, 1999; 17 with a marketed status in Drugs@FDA
Labelers listed (NDC)
23 of which 14 under generic applications, 6 under brand applications, repackagers included
Last listed patent
May 11, 2034 Restasis emulsion; not a generic launch date

Supply and safety

Pharmacy cost (NADAC)
$1.04 per unit Cyclosporine 0.05% eye emulsion
Shortage (FDA)
No current entry
Recalls by its makers (FDA)
7 since 2012 0 Class I among all firms' recalls; latest September 7, 2023; 6 more by firms not listed as its makers
FAERS reports
115,545 through July 30, 2026

What is cyclosporine used for?

From the label: indications and usage

Kidney, 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. Neoral can be used in combination with methotrexate in rheumatoid arthritis patients who do not respond adequately to methotrexate alone. […]

Conditions named in the indications of cyclosporine's FDA labels, with every medicine labeled for each:

From other cyclosporine labels

Organ transplant rejection: INDICATIONS AND USAGE Kidney, Liver, and Heart Transplantation Neoral is indicated for the prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants.

FDA pharmacologic class: Calcineurin Inhibitor Immunosuppressant.

Source: FDA drug label (Neoral), Novartis Pharmaceuticals Corporation, effective August 10, 2026 (SPL set 94461af3-11f1-4670-95d4-2965b9538ae3), via openFDA; the full label on DailyMed

Is there a generic for cyclosporine (Restasis)?

The FDA approved the first generic cyclosporine on October 29, 1999. 24 generic applications are approved; 17 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.

FDA's NDC Directory lists cyclosporine from 14 labelers under a generic (ANDA) application and from 6 brand labelers. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.

The Orange Book lists 4 patents for Restasis emulsion, the last expiring on May 11, 2034; a patent listed only for Vevye solution runs to April 1, 2042. A patent or exclusivity date is not the date a generic goes on sale: court cases and settlements move it either way.

  • 1983 earliest approval on file
  • 1999 first generic approved
  • 2034 last listed patent
  • red ticks recalls

Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)

What do pharmacies pay for cyclosporine (Restasis)?

In CMS's NADAC survey of October 7, 2026, pharmacies paid $1.04 per unit (Cyclosporine 0.05% eye emulsion), down 49% from $2.05 on October 8, 2025. The survey records the price, not the reason for a change; large moves often follow a new generic or a list-price change. Prices per unit in the table differ many-fold by strength, form and brand, so compare like with like. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.

  • Cyclosporine 0.05% eye emulsion (generic)
  • Restasis 0.05% eye emulsion (brand)
$10.33
$1.04
January 2024October 2026
NADAC per unit, October 7, 2026
Strength and formBrand or genericPharmacy cost30 tablets, or one pen or vial12-month change
Cyclosporine 0.05% eye emulsionGeneric$1.04 per unitn/a-49%
Cyclosporine 100 mg capsuleGeneric$7.51 per capsule many times the lowest per-tablet cost; NADAC records the price, not why$225.20+2%
Cyclosporine 25 mg capsuleGeneric$2.60 per capsule$77.87-5%
Cyclosporine modified 100 mgGeneric$1.23 per unitn/a-28%
Cyclosporine modified 100 mg/mLGeneric$2.04 per mLn/a-20%
Cyclosporine modified 25 mgGeneric$0.314 per unitn/a-8%
Cyclosporine modified 50 mgGeneric$0.765 per unitn/a-7%
Cequa 0.09% solutionBrand$10.38 per unit many times the lowest per-tablet cost; NADAC records the price, not whyn/a+3%
Gengraf 25 mg capsuleBrand$1.87 per capsule$55.96+5%
Neoral 100 mg gelatin capsuleBrand$11.77 per capsule many times the lowest per-tablet cost; NADAC records the price, not why$353.19+4%
Neoral 25 mg gelatin capsuleBrand$2.95 per capsule$88.37+4%
Restasis 0.05% eye emulsionBrand$10.31 per unit many times the lowest per-tablet cost; NADAC records the price, not whyn/ano change
Restasis multidose 0.05% eyeBrand$112.32 per mLn/a-0.1%
Vevye 0.1% eye dropBrand$379.87 per mLn/a+3%

Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price

Has cyclosporine been recalled?

The FDA's Enforcement Report lists 13 recalls naming cyclosporine since 2012: 0 Class I (the most serious), 9 Class II, 4 Class III; 0 still ongoing. 6 of them are by firms that FDA's NDC Directory does not list as a maker of cyclosporine and that hold no application for it in Drugs@FDA, such as compounding pharmacies or bulk-ingredient suppliers; the recall notice names the product recalled. A recall names products and lots, not every product of the medicine.

StartedClassCompanyReason
September 7, 2023Class IIISUN PHARMACEUTICAL INDUSTRIES INCSubpotent: Out of Specification result observed for low assay
December 22, 2022Class IIPharmacy Innovations not a listed makerLack of Assurance of Sterility: FDA inspection revealed insanitary conditions at the facility.
September 16, 2022Class IINovartis Pharmaceuticals CorporationCGMP deviations: Out of specification results obtained during routine stability testing for ethanol content.
April 1, 2022Class IIISUN PHARMACEUTICAL INDUSTRIES INCSubpotent Drug and Presence of Particulate Matter: low out-of-specification results obtained for assay and the presence of particulate matter.
May 7, 2021Class IIISUN PHARMACEUTICAL INDUSTRIES INCSubpotent and Presence of Particulates .
February 22, 2021Class IIISUN PHARMACEUTICAL INDUSTRIES INCSubpotent
February 9, 2018Class IIAmerican Pharmaceutical Ingredients LLC not a listed makerCGMP Deviations: Lack of stability data and controls to support the manufacturers assigned retest or expiration date in firm's container/closure system.
February 8, 2017Class IIAmerisource Health ServicesFailed Impurities/Degradations Specifications; out of specification results for Maximum Unknown Impurities and Total Impurities

Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026

What does the cyclosporine label say about other medicines?

The cyclosporine label names 74 other medicines in its interaction, contraindication or warning sections. The labels of 43 other medicines name cyclosporine. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.

Medicine namedSectionWhat the label says
Acetic aciddrug interactionsPharmacodynamic interactions have been reported to occur between cyclosporine and both naproxen and sulindac, in that concomitant use is associated with additive decreases in renal function, as determined by 99m Tc-diethylenetriaminepenta acetic acid (DTPA) and p -aminohippuric acid (PAH) clearances.
Aliskirendrug interactionsCyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and other drugs.
Allopurinoldrug interactionsdiltiazem; fluconazole; azithromycin; methylprednisolone; Allopurinol
Ambrisentandrug interactionsAmbrisentan Coadministration of ambrisentan (5 mg daily) and cyclosporine (100 to 150 mg twice daily initially, then dosing to achieve C min 150 to 200 ng/mL) for 8 days in healthy subjects resulted in mean increases in ambrisentan AUC and C max of approximately 2-fold and 1.5–fold, respectively, compared to …
Amiodaronedrug interactionsnicardipine; itraconazole; clarithromycin; Amiodarone
Amphotericin bdrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Aspirindrug interactionsNo clinically significant pharmacokinetic interactions occurred between cyclosporine and aspirin, ketoprofen, piroxicam, or indomethacin.
Atorvastatindrug interactionsHMG-CoA Reductase Inhibitors (Statins) Literature and postmarketing cases of myotoxicity, including muscle pain and weakness, myositis, and rhabdomyolysis, have been reported with concomitant administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and rarely fluvastatin.
Azithromycindrug interactionsdiltiazem; fluconazole; azithromycin; methylprednisolone; Allopurinol
Bosentandrug interactionsnafcillin; carbamazepine; bosentan; St. John’s Wort
Bromocriptinedrug interactionsverapamil; ketoconazole; erythromycin; Bromocriptine
Carbamazepinedrug interactionsnafcillin; carbamazepine; bosentan; St. John’s Wort
Castor oilcontraindicationsSandimmune injection is also contraindicated in patients with a history of a hypersensitivity reaction to Cremophor ® EL (polyoxyethylated castor oil).
Cimetidinedrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)

Every other medicine the cyclosporine label names

Medicine namedSectionWhat the label says
Ciprofloxacindrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Clarithromycindrug interactionsnicardipine; itraconazole; clarithromycin; Amiodarone
Coal tarboxed warning… lesser extent, methotrexate or other immunosuppressive agents, UVB, coal tar, or radiation therapy, are at an increased risk of developing skin malignancies when taking Neoral.
Colchicinedrug interactionsgentamicin; ketoconazole; colchicine; ranitidine; methotrexate
Dabigatrandrug interactionsCyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and …
Danazoldrug interactions… erythromycin Bromocriptine voriconazole quinupristin/ dalfopristin colchicine danazol imatinib metoclopramide nefazodone oral contraceptives HIV Protease Inhibitors The HIV protease inhibitors (e.g. …
Daunorubicindrug interactions… exposure to anthracycline antibiotics (e.g., doxorubicin, mitoxantrone, daunorubicin) in cancer patients.
Diclofenacdrug interactionstobramycin; diclofenac
Digoxindrug interactionsCyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and …
Diltiazemdrug interactionsdiltiazem; fluconazole; azithromycin; methylprednisolone; Allopurinol
Doxorubicindrug interactions… mg/kg/day) may increase the exposure to anthracycline antibiotics (e.g., doxorubicin, mitoxantrone, daunorubicin) in cancer patients.
Erythromycindrug interactionsverapamil; ketoconazole; erythromycin; Bromocriptine
Etoposidedrug interactions… (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and other drugs.
Fenofibratedrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Fluconazoledrug interactionsdiltiazem; fluconazole; azithromycin; methylprednisolone; Allopurinol
Fluvastatindrug interactions… with lovastatin, simvastatin, atorvastatin, pravastatin, and rarely fluvastatin.
Gentamicindrug interactionsgentamicin; ketoconazole; colchicine; ranitidine; methotrexate
HeparinwarningsThough resolution has occurred after reduction or discontinuation of cyclosporine and 1) administration of streptokinase and heparin or 2) plasmapheresis, this appears to depend upon early detection …
Imatinibdrug interactions… Bromocriptine voriconazole quinupristin/ dalfopristin colchicine danazol imatinib metoclopramide nefazodone oral contraceptives HIV Protease Inhibitors The HIV protease inhibitors (e.g., indinavir …
Indomethacindrug interactionsNo clinically significant pharmacokinetic interactions occurred between cyclosporine and aspirin, ketoprofen, piroxicam, or indomethacin.
Itraconazoledrug interactionsnicardipine; itraconazole; clarithromycin; Amiodarone
Ketoconazoledrug interactionsgentamicin; ketoconazole; colchicine; ranitidine; methotrexate
Ketoprofendrug interactionsNo clinically significant pharmacokinetic interactions occurred between cyclosporine and aspirin, ketoprofen, piroxicam, or indomethacin.
Lovastatindrug interactions… been reported with concomitant administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and rarely fluvastatin.
Melphalandrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Methotrexateboxed warningFor Psoriasis Patients (see also BOXED WARNING above) Psoriasis patients previously treated with PUVA and to a lesser extent, methotrexate or other immunosuppressive agents, UVB, coal tar, or …
Methylprednisolonedrug interactionsdiltiazem; fluconazole; azithromycin; methylprednisolone; Allopurinol
Metoclopramidedrug interactions… voriconazole quinupristin/ dalfopristin colchicine danazol imatinib metoclopramide nefazodone oral contraceptives HIV Protease Inhibitors The HIV protease inhibitors (e.g., indinavir, nelfinavir …
Mitoxantronedrug interactions… increase the exposure to anthracycline antibiotics (e.g., doxorubicin, mitoxantrone, daunorubicin) in cancer patients.
Mycophenolate mofetildrug interactionsConcomitant administration of cyclosporine and mycophenolate mofetil or mycophenolate sodium in transplant patients may decrease the mean exposure of MPA by 20% - 50% when compared with other …
Mycophenolic aciddrug interactionsInteractions Resulting in Decrease of Other Drug Levels Cyclosporine inhibits the enterohepatic circulation of mycophenolic acid (MPA).
Nafcillindrug interactionsnafcillin; carbamazepine; bosentan; St. John’s Wort
Naproxendrug interactionstrimethoprim with sulfamethoxazole; naproxen
Nefazodonedrug interactions… quinupristin/ dalfopristin colchicine danazol imatinib metoclopramide nefazodone oral contraceptives HIV Protease Inhibitors The HIV protease inhibitors (e.g., indinavir, nelfinavir, ritonavir, and …
Nelfinavirdrug interactions… Protease Inhibitors The HIV protease inhibitors (e.g., indinavir, nelfinavir, ritonavir, and saquinavir) are known to inhibit cytochrome P-450 3A and thus could potentially increase the …
Nicardipinedrug interactionsnicardipine; itraconazole; clarithromycin; Amiodarone
Nifedipinedrug interactionsThe concomitant use of nifedipine should be avoided in patients in whom gingival hyperplasia develops as a side effect of cyclosporine.
Octreotidedrug interactionsrifampin; oxcarbazepine; octreotide
Orlistatdrug interactionsCompounds that decrease cyclosporine absorption, such as orlistat, should be avoided.
Oxcarbazepinedrug interactionsrifampin; oxcarbazepine; octreotide
Phenobarbitaldrug interactionsphenobarbital; orlistat
Phenytoindrug interactionsphenytoin; sulfinpyrazone
Piroxicamdrug interactionsNo clinically significant pharmacokinetic interactions occurred between cyclosporine and aspirin, ketoprofen, piroxicam, or indomethacin.
Pravastatindrug interactions… administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and rarely fluvastatin.
Prednisolonedrug interactionsCyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and …
Ranitidinedrug interactionsgentamicin; ketoconazole; colchicine; ranitidine; methotrexate
Repaglinidedrug interactionsCyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and …
Rifabutindrug interactionsRifabutin Rifabutin is known to increase the metabolism of other drugs metabolized by the cytochrome P-450 system.
Rifampindrug interactionsrifampin; oxcarbazepine; octreotide
Ritonavirdrug interactions… Inhibitors The HIV protease inhibitors (e.g., indinavir, nelfinavir, ritonavir, and saquinavir) are known to inhibit cytochrome P-450 3A and thus could potentially increase the concentrations of …
Simvastatindrug interactions… reported with concomitant administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and rarely fluvastatin.
Sirolimusdrug interactions… inhibitors (statins), aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and other drugs.
Sulindacdrug interactionsvancomycin; sulindac
Tacrolimusdrug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Terbinafinedrug interactions… oxcarbazepine octreotide phenobarbital orlistat phenytoin sulfinpyrazone terbinafine ticlopidine Bosentan Coadministration of bosentan (250 to 1000 mg every 12 hours based on tolerability) and …
Tobramycindrug interactionstobramycin; diclofenac
Trimethoprimdrug interactionstrimethoprim with sulfamethoxazole; naproxen
Vancomycindrug interactionsvancomycin; sulindac
Verapamildrug interactionsverapamil; ketoconazole; erythromycin; Bromocriptine
Voriconazoledrug interactionsvoriconazole; quinupristin/ dalfopristin; colchicine

Other labels that name cyclosporine

Check cyclosporine against other medicines

Source: FDA drug label (Neoral), Novartis Pharmaceuticals Corporation, effective August 10, 2026 (SPL set 94461af3-11f1-4670-95d4-2965b9538ae3), via openFDA; the full label on DailyMed

What do FAERS reports show for cyclosporine?

The FDA Adverse Event Reporting System holds 115,545 reports that list cyclosporine among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 14,506 are coded as a death and 28,361 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.

Reports received each year

The most reported reactions

  • Drug Ineffective (a use or a product term, not a reaction)14,208
  • Eye Irritation10,006
  • Off Label Use (a use or a product term, not a reaction)9,573
  • Eye Pain (named in the label)4,619
  • Product Use In Unapproved Indication (a use or a product term, not a reaction)4,322
  • Pyrexia4,173
  • Headache (named in the label)3,888
  • Nausea (named in the label)3,778

Side effects: the label's list and every FAERS reaction

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026

What else is labeled for the same conditions as cyclosporine?

5 other medicines are given the same way (oral) and in the same FDA class as cyclosporine or labeled mainly for the same use (organ transplant rejection), the same class first. Organ transplant rejection lists all 13 medicines labeled for it, by any route. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.

MedicineShared indicationGeneric labelers (oral)Pharmacy costShortage
TacrolimusOrgan transplant rejection30 labelers$0.123 per capsule 0.5 mg capsule (immediate release)No current entry
Mycophenolate mofetilOrgan transplant rejection30 labelers$0.138 per capsule 250 mg capsuleNo current entry
Mycophenolic acidOrgan transplant rejection16 labelers$0.0996 per tablet 180 mg tabletNo current entry
SirolimusOrgan transplant rejection18 labelers$0.723 per tablet 1 mg tabletNo current entry
AzathioprineRheumatoid arthritis, Organ transplant rejection16 labelers$0.124 per tablet 50 mg tabletNo current entry

Every medicine labeled for the same conditions as cyclosporine

Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)

How does cyclosporine compare with medicines for the same use?

2 side-by-side pages set cyclosporine beside a medicine whose label shares a use: approvals, generics, pharmacy cost, warnings and supply.

What next?

Alternatives to cyclosporine
5 medicines for the same use
Other calcineurin inhibitor immunosuppressants
the pharmacologic class, with prices and generics
Cyclosporine side effects
the label's list beside FAERS reports
Check an interaction
what two or more labels say about each other