Buy Generic Neoral Online

Generic Neoral Information

Introduction

Neoral is an oral formulation of cyclosporine, a calcineurin inhibitor used primarily to suppress the immune system. In Hong Kong, Neoral is prescribed for organ‑transplant maintenance, severe psoriasis, and certain autoimmune arthritides. The medication belongs to the “Skin Care, Arthritis” group because of its efficacy in dermatologic and rheumatologic conditions. Cyclosporine is the active compound, and the product is manufactured by several licensed pharmaceutical companies under the Neoral brand name.

What is Neoral?

Neoral is a hard‑gelatin capsule that delivers cyclosporine in a microemulsion formulation, improving oral absorption compared with earlier cyclosporine products. It is classified as an immunosuppressant and to the calcineurin‑inhibitor class. The preparation was developed in the early 199s to overcome the variable bio‑availability of the original cyclosporine formulation (Sandimmun).

Neoral contains the same active compound as other cyclosporine products such as Sandimmun, Gengraf, and Nephro‑Cy. While the brand name Neoral is widely recognized, the underlying molecule is cyclosporine, and generic versions are available worldwide.

How Neoral Works

Cyclosporine binds to the intracellular protein cyclophilin in T‑lymphocytes. The cyclosporine‑cyclophilin complex inhibits calcineurin, a phosphatase required for the activation of nuclear factor of activated T‑cells (NF‑AT). Blocking NF‑AT prevents transcription of interleukin‑2 (IL‑2) and other cytokines essential for T‑cell proliferation.

The result is a dose‑dependent reduction in cellular immunity, which limits graft rejection after organ transplantation and dampens the inflammatory cascade in skin and joint diseases. Oral absorption of Neoral occurs within 1–2 hours; peak plasma concentrations are reached in 4–6 hours. The drug is extensively metabolised by hepatic CYP3A4 and eliminated mainly in the bile; the terminal half‑life ranges from 6 to 12 hours, necessitating twice‑daily dosing in most regimens.

Conditions Treated with Neoral

• Kidney, liver, and heart transplantation – Neoral is part of standard maintenance immunosuppression to prevent acute and chronic rejection.
• Severe plaque psoriasis – When topical therapy, phototherapy, or biologics are unsuitable, cyclosporine provides rapid reduction of erythema and plaque thickness.
• Rheumatoid arthritis refractory to conventional DMARDs – Cyclosporine can be used as a bridge therapy to control disease activity.
• Uveitis and other ocular inflammatory disorders – Systemic cyclosporine reaches therapeutic concentrations in intra‑ocular tissues.

In Hong Kong, transplant activity accounts for approximately 650 kidney and 200 liver transplants per year (Hospital Authority data, 2023). Severe psoriasis prevalence is estimated at .5 % of the adult population, creating a clear clinical need for an effective immunosuppressant such as Neoral.

Who is Neoral For?

• Adult transplant recipients who have stable graft function and require long‑term immunosuppression.
• Patients with extensive plaque psoriasis that does not respond adequately to topical agents or phototherapy.
• Individuals with active rheumatoid arthritis who have failed at least one disease‑modifying antirheumatic drug (DMARD).
• Patients with non‑infectious uveitis where rapid control of inflammation is critical.

Neoral is generally unsuitable for:

• Children and adolescents, unless specifically prescribed by a transplant specialist.
• Pregnant or lactating women, due to documented teratogenicity and secretion in breast milk.
• Patients with uncontrolled hypertension, severe renal impairment (creatinine clearance < 30 mL/min), or uncontrolled infections.

Risks, Side Effects, and Interactions

Common

• Nephrotoxicity – elevation of serum creatinine, reduced glomerular filtration.
• Hypertension – increased systolic/diastolic blood pressure, often dose‑related.
• Hypertrichosis – excessive hair growth on face and limbs.
• Gingival hyperplasia – overgrowth of gum tissue, especially in dental plaque‑rich areas.

Rare

• Hepatotoxicity – mild to moderate increase in transaminases; usually reversible upon dose adjustment.
• Tremor – fine tremor of the hands or limbs, more frequent at higher plasma concentrations.
• Peripheral neuropathy – sensory changes, tingling, or numbness, typically reversible.

Serious

• Severe nephrotoxicity – acute kidney injury requiring dialysis.
• Neurotoxicity – seizures, encephalopathy, or posterior reversible encephalopathy syndrome (PRES).
• Malignancies – increased long‑term risk of lymphoma and skin cancers due to immunosuppression.
• Infections – opportunistic infections such as cytomegalovirus, Pneumocystis jirovecii pneumonia, or severe bacterial sepsis.

Drug–Drug Interactions

• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin, grapefruit juice) markedly increase cyclosporine levels → risk of toxicity.
• CYP3ducers (e.g., rifampicin, carbamazepine, phenytoin, St. John’s wort) reduce cyclosporine exposure → loss of efficacy.
• Nephrotoxic agents (e.g., aminoglycosides, non‑steroidal anti‑inflammatory drugs, vancomycin) potentiate renal injury.
• Vaccines – live attenuated vaccines should be avoided while on immunosuppression.

Practical Use: Dosing, Missed Dose, Overdose

• Standard adult dosing for transplantation: 3–5 mg/kg per day divided into two doses (e.g., 2 mg/kg every 12 hours). Adjustments are guided by trough blood concentrations (target 100–200 ng/mL).
• Psoriasis: 2.5–5 mg/kg per day, usually for ≤ 12 months due to long‑term toxicity concerns.
• Rheumatoid arthritis: 2.5 mg/kg per day in two divided doses, with regular monitoring of renal function and blood pressure.

Missed dose – Take the missed dose as soon as remembered if it is > 4 hours before the next scheduled dose. Do not double the dose.

Overdose – Seek emergency medical attention. Symptoms may include severe tremor, vomiting, hypertension, and renal failure. Supportive care and hemodialysis are options for life‑threatening toxicity.

Precautions –

• Take Neoral consistently with respect to meals; a high‑fat meal can increase absorption.
• Avoid alcohol excess, which can exacerbate hypertension and liver strain.
• Monitor renal function, blood pressure, lipid profile, and cyclosporine trough levels at least every 2–4 weeks during dose titration.

Buying Neoral from Our Online Pharmacy

Patients in Hong Kong can obtain Neoral through our online pharmacy, which sources the medication from accredited overseas manufacturers that comply with GMP standards.

• Affordable pricing – We negotiate near‑manufacturer costs, passing savings directly to you.
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Choosing our online pharmacy provides a secure, cost‑effective route for patients who need reliable access to Neoral while navigating limited local availability or insurance coverage gaps.

FAQ

• What is the difference between Neoral and other cyclosporine brands such as Sandimmun?
  Neoral uses a microemulsion formulation that offers more predictable absorption compared with the original Sandimmun oil‑based capsule. Both contain cyclosporine, but Neoral often achieves higher and steadier blood levels at equivalent doses.

• Can Neoral be stored at temperatures above room temperature?
  Neoral should be kept at 15 °C–30 °C (59 °F–86 °F). Exposure to excessive heat (above 30 °C) may degrade the microemulsion, reducing potency.

• Does Neoral have a taste‑masking coating?
  The hard‑gelatin capsule prevents direct contact of cyclosporine with the oral mucosa, thus eliminating any bitter taste that the native powder would have.

• How long does it take for blood cyclosporine levels to stabilize after starting therapy?
  Steady‑state concentrations are usually reached after 5–7 days of consistent twice‑daily dosing, but therapeutic drug monitoring is recommended earlier to adjust the dose safely.

• Is it safe to travel internationally with Neoral in hand luggage?
  Yes, provided the medication is in its original packaging with a clear label. Carry a copy of the prescription or a physician’s letter if requested by customs authorities.

• Do any over‑the‑counter supplements interfere with Neoral?
  Herbal products such as St. John’s wort (a CYP3A4 inducer) can lower cyclosporine levels, while kava or large amounts of grapefruit juice (CYP3A4 inhibitors) can increase them, raising the risk of toxicity.

• Are there geographic formulation differences for Neoral?
  The active ingredient and microemulsion technology are consistent worldwide, but excipient profiles (e.g., capsule gelatin type) may vary slightly to meet regional regulatory requirements.

• Can Neoral be used for prevention of graft‑versus‑host disease (GVHD) after bone‑marrow transplant?
  While cyclosporine is a standard component of GVHD prophylaxis, the specific product (Neoral versus other cyclosporine brands) is chosen by the transplant centre based on institutional protocols.

• What are the legal requirements for personal import of Neoral into Hong Kong?
  Hong Kong permits import of up to a 30‑day supply of prescription medication for personal use, provided the recipient holds a valid prescription and the product is for personal consumption only.

• Does Neoral interact with common antihypertensive drugs?
  Calcium‑channel blockers (e.g., amlodipine) can increase cyclosporine concentrations via CYP3A4 inhibition, necessitating closer blood‑level monitoring and possible dose adjustment.

Glossary

Calcineurin inhibitor

A class of drugs that block the phosphatase enzyme calcineurin, preventing activation of T‑cells and reducing immune responses.

Therapeutic drug monitoring (TDM)

Measurement of drug concentrations in blood at designated intervals to maintain a concentration within a target range that maximizes efficacy while minimizing toxicity.

Microemulsion

A thermodynamically stable mixture of oil and water stabilized by surfactants, used in Neoral to enhance cyclosporine absorption.

Nephrotoxicity

Kidney damage caused by a substance, indicated by rising serum creatinine, reduced glomerular filtration, or electrolyte disturbances.

⚠️ Disclaimer

The information provided about Neoral is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Neoral for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.