• powerful drugs – main use is following transplants – also used for rheumatoid arthritis, psoriasis. Also has been used in early stages of type 1 diabetes.
• acts by suppressing production of interleukin-2 and other cytokines by binding to cyclophilin inhibits calcineurin (enzyme in cytokine synthesis pathway)
• may be used concurrently with prednisone or azathioprine
• adverse events – increased risk for infection and kidney toxicity (in up to 75%)