Sandimmune

Avoid grapefruit and grapefruit juice while taking this drug. Also avoid the antidepressant herb St. John's wort. This over-the-counter herbal remedy reduces the effect of Sandimmune and Neoral, and can lead to organ rejection.

If Sandimmune is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Sandimmune with the following:

Allopurinol (Zyloprim)
Amiodarone (Cordarone)
Amphotericin B (Fungizone, Abelcet)
Atorvastatin (Lipitor)
Bromocriptine (Parlodel)
Calcium-blocking heart and blood pressure medications such as Adalat, Calan, Cardene, Cardizem, and Procardia
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Colchicine
Danazol (Danocrine)
Diclofenac (Voltaren, Cataflam)
Digoxin (Lanoxin, Lanoxicaps)
Erythromycin (E.E.S., Erythrocin, others)
Fluconazole (Diflucan)
Fluvastatin (Lescol)
Gentamicin (Garamycin)
Indinavir (Crixivan)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lovastatin (Mevacor)
Melphalan (Alkeran)
Methotrexate
Methylprednisolone (Depo-Medrol, Medrol, Solu-Medrol)
Metoclopramide (Reglan)
Nafcillin (Unipen)
Nelfinavir (Viracept)
Nonsteroidal anti-inflammatory drugs such as Clinoril and Naprosyn
Octreotide (Sandostatin)
Orlistat (Xenical)
Phenobarbital
Phenytoin (Dilantin)
Potassium-sparing diuretics (Dyrenium, Midamor, Aldactone)
Pravastatin (Pravachol)
Prednisolone (Delta-Cortef, Prelone)
Quinupristin (Synercid)
Ranitidine (Zantac)
Rifampin (Rifadin, Rifamate, Rimactane)
Ritonavir (Norvir)
Saquinavir (Fortovase)
Simvastatin (Zocor)
Ticlopidine (Ticlid)
Tacrolimus (Prograf)
Tobramycin (Nebcin)
Trimethoprim/sulfamethoxazole (Bactrim, Septra)
Vancomycin (Vancocin)

Special information if you are pregnant or breastfeeding

The effects of Sandimmune in pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Sandimmune should be used during pregnancy only if the benefit justifies the potential risk to the unborn child. Since Sandimmune appears in breast milk, it should not be used during breastfeeding. If you are a new mother, you may need to choose between taking Sandimmune and breastfeeding your baby.