BIORAL 100MG CAPSULE ONLINE AT BEST PRICE IN PAKISTAN

GENERIC: Cyclosporin 100mg (Micro Emulsion)

MANUFACTURER: Allmed Laboratories

QUANTITY:

Pack of 50 capsules

INDICATION

Bioral 100mg Cap is a calcineurin inhibitor immunosuppressant used to prevent organ rejection following kidney, liver, and heart transplantation. It is also indicated for the treatment of severe rheumatoid arthritis unresponsive to methotrexate, severe plaque psoriasis, nephrotic syndrome (steroid-resistant), and Crohn's disease. The micro-emulsion formulation provides more predictable bioavailability compared to standard cyclosporin preparations.

MECHANISM OF ACTION

Cyclosporin binds to the cytosolic protein cyclophilin (immunophilin) in T-lymphocytes. The cyclosporin-cyclophilin complex inhibits calcineurin, a phosphatase required for the activation of transcription factor NFAT (nuclear factor of activated T-cells). This blocks the transcription of interleukin-2 (IL-2) and other cytokines essential for T-cell proliferation and activation. The selective suppression of T-cell-mediated immune responses prevents transplant rejection and reduces immune-driven tissue damage in autoimmune conditions. The micro-emulsion (ME) formulation forms a spontaneous emulsion in the GI tract, allowing absorption independent of bile flow and providing more consistent pharmacokinetics.

DOSAGE AND ADMINISTRATION

•      Organ transplantation: initial dose 10 to 15mg/kg/day in 2 divided doses, starting 12 hours before transplant; taper to maintenance dose of 2 to 6mg/kg/day based on trough levels

•      Rheumatoid arthritis: 2.5mg/kg/day in 2 divided doses; may increase to maximum 4mg/kg/day

•      Severe psoriasis: 2.5mg/kg/day in 2 divided doses; maximum 5mg/kg/day

•      Nephrotic syndrome: 5mg/kg/day (adults) in 2 divided doses

•      Monitor whole blood trough cyclosporin levels regularly; therapeutic range is indication-dependent

•      Take consistently with or without food but maintain the same pattern each day

•      Avoid grapefruit and grapefruit juice throughout treatment

SIDE EFFECTS

Common:

•      Nephrotoxicity — dose-dependent and the most important adverse effect; monitor creatinine

•      Hypertension — occurs in up to 50% of patients; requires antihypertensive therapy

•      Hypertrichosis (increased body hair) and gingival hyperplasia

•      Tremor, headache, paresthesia

•      Nausea, diarrhea, abdominal discomfort

Less common:

•      Hepatotoxicity — elevated liver enzymes and bilirubin

•      Hyperkalemia and hypomagnesaemia from renal tubular effects

•      Increased risk of opportunistic infections (bacterial, viral, fungal)

•      Lymphoma and other malignancies with prolonged immunosuppression

•      Neurotoxicity: confusion, encephalopathy, seizures at high levels

NOT RECOMMENDED IN

•      Known hypersensitivity to cyclosporin or any component of the formulation

•      Uncontrolled hypertension

•      Uncontrolled infections

•      Malignancy (except non-melanoma skin cancer) — use with extreme caution

•      Renal impairment in non-transplant indications — use only if benefit clearly outweighs risk

•      Concurrent use with bosentan, pitavastatin, rosuvastatin, or simvastatin (significantly increased statin toxicity)

DRUG INTERACTIONS

Cyclosporin is a major CYP3A4 and P-glycoprotein substrate as well as an inhibitor. Strong CYP3A4 inhibitors (ketoconazole, voriconazole, erythromycin, clarithromycin, diltiazem, verapamil, grapefruit juice) significantly increase cyclosporin levels, increasing toxicity risk. Strong CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St. John's Wort) markedly reduce cyclosporin levels, risking rejection. Cyclosporin inhibits the organic anion transporting polypeptide (OATP) and can dramatically increase levels of statins (especially simvastatin, lovastatin, rosuvastatin) — risk of rhabdomyolysis; if a statin is needed, use pravastatin or fluvastatin at lowest doses. Combined use with nephrotoxic drugs (aminoglycosides, NSAIDs, amphotericin B, vancomycin) significantly increases the risk of acute kidney injury. Potassium-sparing diuretics increase hyperkalemia risk. Methotrexate levels are increased by cyclosporin.

STORAGE INSTRUCTIONS

Store Bioral 100mg capsules at room temperature below 25°C. Protect from light and moisture. Keep in original blister packaging. Do not freeze. Store out of reach of children.

WHERE TO BUY

Buy Bioral 100mg Cap online from Dawa Healthcare Pharmacy with a valid specialist prescription. Check the Bioral 100mg capsule price in Pakistan and learn about Bioral 100mg capsule uses from our expert pharmacists. Same-day delivery is available in Karachi. Dawa Healthcare Pharmacy provides nationwide delivery across Pakistan.