= Cyclosporin A
Cyclic polypeptide systhesised by Tolypocladium inflatum or Cyclindrocarpon lucidum.


Transplant, RhA, recalcitrant psoriasis.


Binds calcineurin, and hence reduces IL2 synthesis, resulting in inhibition of T-cells in G0 or G1 of the cell cycle. No myelosuppressive effect.

Adverse effects

Dose-dependent nephrotoxicity. Hypertension, hirsutism, gingival hyperplasia.

Interesting points

In renal transplant, it can be difficult to differentiate between graft rejection and cyclosporine nephrotoxicity. Toxicity is suggested by:
  1. absence of fever
  2. no graft tenderness
  3. no graft enlargement
Diagnosis may only be confirmed by biopsy.