Sandimmun/Sandimmun Neoral Overdosage

Sandimmun: Data are limited on acute ciclosporin overdose. Should an overdose occur, symptomatic treatment should be instituted, along with general supportive measures. Any signs of renal dysfunction should regress once the medicine has been withdrawn.
Neither dialysis nor charcoal haemoperfusion will clear ciclosporin adequately from the system.
Sandimmun Neoral: Symptoms: Data are limited on acute ciclosporin overdose. Oral doses of up to 10 g (about 150 mg/kg) have been tolerated with relatively minor clinical consequences, such as vomiting, drowsiness, headache, tachycardia and, in a few patients, moderately severe, reversible impairment of renal function. However, serious symptoms of intoxication have been reported following accidental parenteral overdose in premature neonates.
Treatment: In all cases of overdose, general supportive measures should be followed and symptomatic treatment applied. Forced emesis and gastric lavage may be of value within the first hour after oral intake.
Ciclosporin is not dialysable to any great extent, nor is it well cleared by charcoal haemoperfusion.