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Related Experiment Videos

Cyclosporine-induced anaphylaxis.

R A Kuiper1, M M Malingré, J H Beijnen

  • 1Department of Pharmacy and Pharmacology, Slotervaart Hospital/The Netherlands Cancer Institute, Amsterdam.

The Annals of Pharmacotherapy
|August 6, 2000
PubMed
Summary

Anaphylactic shock can occur after taking oral cyclosporine capsules, even with first-time use. This reaction may be linked to the capsule

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Area of Science:

  • Immunology
  • Pharmacology
  • Oncology

Background:

  • Cyclosporine is an immunosuppressant used in various medical conditions.
  • Anaphylactic reactions have been reported with intravenous and oral solution formulations of cyclosporine.
  • The excipient Cremophor EL has been implicated in previous cyclosporine-induced anaphylaxis.

Observation:

  • A patient receiving oral cyclosporine capsules (Neoral) for metastatic breast carcinoma experienced anaphylaxis shortly after ingestion.
  • Symptoms included severe hypotension, bradycardia, tachycardia, dyspnea, and decreased consciousness.
  • The patient recovered fully after prompt administration of epinephrine and supportive care.

Findings:

  • This case represents the first reported instance of anaphylaxis following oral cyclosporine capsule ingestion.
  • The reaction is hypothesized to be associated with polyoxyl 40 hydrogenated castor oil, a component of the capsule formulation.
  • This contrasts with previously reported anaphylaxis linked to Cremophor EL in other cyclosporine formulations.

Implications:

  • Clinicians should be aware of the potential for anaphylaxis with oral cyclosporine capsules, not just other formulations.
  • The specific excipients in different cyclosporine formulations may influence the risk of hypersensitivity reactions.
  • Further investigation into the safety profile of cyclosporine excipients is warranted.

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