Sandimmune cannot be used interchangeably with Gengraf or Neoral because they are not bioequivalent.
Prevention of Transplant Rejection (Sandimmune)
- PO (Adults and Children ): 14–18 mg/kg/dose 4–12 hr before transplant; then 5–15 mg/kg/day divided every 12–24 hr postoperatively; taper by 5% weekly to maintenance dose of 3–10 mg/kg/day.
- IV (Adults and Children ): 5–6 mg/kg/dose 4–12 hr before transplant; then 2–10 mg/kg/day in divided doses every 8–24 hr; change to PO as soon as possible.
Prevention of Transplant Rejection (Gengraf or Neoral)
- PO (Adults and Children ): 4–12 mg/kg/day divided every 12 hr (dose varies depending on organ transplanted).
Rheumatoid Arthritis (Gengraf or Neoral)
- PO (Adults and Children ): 2.5 mg/kg/day given in 2 divided doses; may ↑ by 0.5–0.75 mg/kg/day after 8 and 12 wk, up to 4 mg/kg/day. ↓ dose by 25–50% if adverse reactions occur.
Severe Psoriasis (Gengraf or Neoral)
- PO (Adults ): 2.5 mg/kg/day given in 2 divided doses, for at least 4 wk; then may ↑ by 0.5 mg/kg/day every 2 wk, up to 4 mg/kg/day. ↓ dose by 25–50% if adverse reactions occur.
Autoimmune Diseases (Neoral only)
- PO (Adults and Children ): 1–3 mg/kg/day.
