Cyclosporine (Neoral)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Cyclosporine

What it is

Ciclosporin (cyclosporine) is an immunosuppressant of the calcineurin inhibitor group, first found in a soil fungus. It blocks the signal T cells need to become active. It is used after organ and bone marrow transplants to prevent rejection, and for severe psoriasis, eczema and rheumatoid arthritis; as eye drops it treats dry eye. Blood levels are monitored. It is sold as Neoral and Sandimmune, among other names.

How genes come into it

Ciclosporin is broken down by CYP3A4 and CYP3A5 and pumped out of cells by ABCB1, the same genes studied for tacrolimus. Studies link CYP3A5 expressers and some CYP3A4 versions to lower levels, but the effect is smaller and less consistent than for tacrolimus, so there is no CPIC or DPWG guideline. Studies have also looked at POR and ABCB1, with weaker evidence.

What research found

Every published finding on gene variants and Cyclosporine. Upload your DNA file to see which of these rows apply to you.

Rated evidence (26 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

CYP3A5 CYP3A5*1, CYP3A5*3: Level 3. Metabolism/PK: Kidney Transplantation. 11.

CYP3A4 rs35599367: Level 3. Other: Organ Transplantation. 7.

ABCB1 rs1128503: Level 3. Dosage: Kidney Transplantation, Myasthenia Gravis. 4.

ABCB1 rs1045642: Level 3. Metabolism/PK: Transplantation. 4.

Metabolism (31 findings)

Studies of how quickly the body processes this medication.

ABCB1 rs1045642: Genotype GG is associated with decreased concentrations of cyclosporine in people with Kidney Transplantation as compared to genotype AA.

CYP3A4 CYP3A4*1, CYP3A4*18: CYP3A4 *18/*18 is associated with increased metabolism of cyclosporine in people with Kidney Transplantation as compared to CYP3A4 *1/*1 + *1/*18.

CYP3A4 CYP3A4*1, CYP3A4*18: CYP3A4 *1/*1 is associated with increased concentrations of cyclosporine in men as compared to CYP3A4 *1/*18.

CYP3A4 CYP3A4*1, CYP3A4*22: CYP3A4 *1/*1 is associated with increased clearance of cyclosporine in people with Kidney Transplantation as compared to CYP3A4 *1/*22 + *22/*22.

Response (10 findings)

Studies of how well it worked in people carrying a variant.

rs2874116: Allele G is associated with increased response to cyclosporine in people with Psoriasis as compared to allele A.

ABCB1 rs1045642: Allele A is associated with decreased response to cyclosporine in people with Psoriasis as compared to allele G.

CALM1 rs12885713: Allele T is associated with increased response to cyclosporine in people with Psoriasis as compared to allele C.

CYP3A4 rs4646437: Genotypes AG + GG is associated with increased response to cyclosporine in people with Kidney Transplantation as compared to genotype AA.

Dosing (16 findings)

Studies of how much of the drug people needed or tolerated.

ABCB1 rs2032582: Genotypes AC + CC is associated with increased dose of cyclosporine in people with Kidney Transplantation as compared to genotypes AA + CT.

ABCB1 rs2032582: Genotypes AC + CC is associated with decreased dose-adjusted trough concentrations of cyclosporine in people with Kidney Transplantation as compared to genotypes AA + CT.

CYP3A5 CYP3A5*1, CYP3A5*3: CYP3A5 *3 is associated with decreased dose of cyclosporine in people with Kidney Transplantation as compared to CYP3A5 *1.

CYP3A5 rs776746: Genotype CC is associated with decreased dose of cyclosporine as compared to genotypes CT + TT.

Side effects (2 findings)

Studies of side effects in people carrying a variant.

ABCB1 rs9282564: Genotype CT is associated with increased concentrations of cyclosporine in people with heart transplantation as compared to genotype TT.

CYP3A4 rs35599367: Genotypes AA + AG are associated with decreased clearance of cyclosporine in people with Kidney Transplantation as compared to genotype GG.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

Related Drugs

More drugs from the same category

CellCept (Immunosuppressants)

Imuran (Immunosuppressants)

Myfortic (Immunosuppressants)

Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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