Conimune ME
✅ Boosts Immune System
✅ Enhances Energy Levels
✅ Promotes Healthy Skin
✅ Supports Digestive Health
✅ Improves Mental Clarity
Conimune ME contains Cyclosporine
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Conimune ME?
Conimune ME is an oral capsule from Concord Drugs containing cyclosporine 25 mg in the modified microemulsion (ME) formulation — the standard equivalent of Sandimmune Neoral. Cyclosporine is a calcineurin inhibitor that blocks T-cell IL-2 production, broadly suppressing the cellular immune response. Standard adult dose: 2.5–5 mg/kg/day in 2 divided doses, titrated to whole-blood trough level (typically 100–300 ng/mL depending on indication). Used for solid-organ transplant rejection prevention, severe rheumatoid arthritis, severe psoriasis, severe atopic dermatitis, nephrotic syndrome (steroid-resistant), Behçet's disease, severe ulcerative colitis flare, and other severe autoimmune conditions resistant to first-line therapy. Mandatory monitoring before and during therapy: trough cyclosporine level, blood pressure, serum creatinine and urea, magnesium, potassium, fasting lipids, fasting glucose, hepatic enzymes. The drug has a massive interaction surface through CYP3A4 and P-glycoprotein — statins (rhabdomyolysis), grapefruit juice, azole antifungals, macrolide antibiotics, and many anti-epileptics all change cyclosporine levels significantly. Modified microemulsion and original Sandimmune are NOT bioequivalent — never switch formulations without re-checking trough levels.
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What Is Conimune ME?
Conimune ME is an oral soft-gelatin capsule manufactured by Concord Drugs containing cyclosporine in the modified microemulsion (ME) formulation — the same delivery system as the originator brand Sandimmune Neoral. Cyclosporine is an 11-amino-acid cyclic peptide originally isolated from the soil fungus Tolypocladium inflatum in the 1970s; its discovery transformed solid-organ transplantation by making routine kidney, liver, heart and lung transplant feasible.
Conimune ME is Concord Drugs' branded generic cyclosporine in the modified microemulsion (ME) formulation — the standard equivalent of Sandimmune Neoral. The 25 mg capsule strength is the building block for adult dosing across solid-organ transplant rejection prevention, severe rheumatoid arthritis, severe psoriasis, severe atopic dermatitis, nephrotic syndrome and other severe autoimmune indications.
About the “ME” in the brand name. Cyclosporine is a notoriously hydrophobic molecule and the original Sandimmune oil-based formulation had highly variable, food-dependent absorption. The modified microemulsion (Neoral / Sandimmune ME / Conimune ME) pre-emulsifies the drug with a self-microemulsifying lipid system, giving much more reliable absorption that is largely independent of bile flow. The two formulations have different bioavailability and are NOT considered bioequivalent — switching between them requires a fresh trough-level check and may need a dose adjustment.
How Does Conimune ME Work?
Cyclosporine binds cyclophilin A inside T-lymphocytes; the cyclosporine-cyclophilin complex then inhibits calcineurin, a phosphatase that activates the nuclear factor of activated T-cells (NFAT). With NFAT suppressed, the T-cell cannot transcribe IL-2 and other key cytokines, and the cellular immune response is broadly dampened.
- Strong inhibition of T-cell-driven inflammation — the basis for transplant rejection prevention and treatment of severe T-cell-mediated autoimmune disease.
- Less effect on B-cells and humoral immunity than steroids or azathioprine — useful when the goal is selective T-cell suppression.
- No bone-marrow suppression at therapeutic doses — one of the few immunosuppressants that does not lower blood counts directly.
- Inhibits cytokine production by skin and intestinal epithelium, which contributes to its efficacy in psoriasis, atopic dermatitis and inflammatory bowel disease.
Onset: detectable immune suppression within 1–2 days; full clinical effect in autoimmune disease at 4–8 weeks. Plasma half-life ~8–15 hours; metabolised by CYP3A4 in the liver and gut wall and excreted predominantly in bile.
Toepassingen en Indicaties
- Solid-organ transplant — kidney, liver, heart, lung, pancreas. Combined with mycophenolate mofetil and tapering steroid; sometimes substituted for tacrolimus where it is not tolerated.
- Severe rheumatoid arthritis — reserved for active disease unresponsive to methotrexate and one other DMARD; often combined with methotrexate in difficult cases.
- Severe plaque psoriasis — rapid-acting (4–8 weeks), used short-term to gain control, then transitioned to safer long-term agents.
- Severe atopic dermatitis — another rapid-acting role; useful for short courses while transitioning to dupilumab or JAK inhibitors.
- Nephrotic syndrome — steroid-resistant minimal change disease, focal segmental glomerulosclerosis, and selected membranous nephropathy.
- Severe ulcerative colitis flare — IV cyclosporine for 7–10 days as a rescue therapy in steroid-refractory severe UC; bridge to longer-acting therapy or surgery.
- Behçet's disease, uveitis, aplastic anaemia, pyoderma gangrenosum, severe lichen planus, graft-vs-host disease.
- Severe atopic keratoconjunctivitis — topical cyclosporine drops are first-line; oral cyclosporine reserved for severe cases.
Conimune ME is niet appropriate for: mild-to-moderate psoriasis or eczema (topicals first), routine RA (methotrexate first), or anyone who cannot commit to the monitoring schedule.
Conimune ME Dosage and How to Take
Conimune ME is supplied at 25 mg. Adult dose is calculated by weight and titrated to whole-blood trough cyclosporine concentration. Doses below are starting points only — the trough level guides ongoing dosing.
Typical adult starting doses by indication
| Indicatie | Startdosis | Target trough (whole blood) |
|---|---|---|
| Renal transplant (induction) | 7–10 mg/kg/day in 2 divided doses | 200–300 ng/mL early; 100–200 ng/mL maintenance |
| Severe rheumatoid arthritis | 2.5 mg/kg/day in 2 divided doses; titrate to 5 mg/kg/day max | Trough not routinely measured; clinical response and toxicity guide |
| Severe psoriasis | 2.5–5 mg/kg/day in 2 divided doses | Trough not routinely measured; max 12-week courses then transition |
| Severe atopic dermatitis | 3–5 mg/kg/day in 2 divided doses | Trough not routinely measured; short-term use preferred |
| Nephrotic syndrome | 3–5 mg/kg/day in 2 divided doses | 100–200 ng/mL |
| Severe ulcerative colitis (oral, after IV induction) | 5–8 mg/kg/day in 2 divided doses | 200–400 ng/mL during bridge; tapered as steroid is added |
How to Take Conimune ME Properly
- Take twice daily, at the same times every day, ideally 12 hours apart (e.g. 08:00 and 20:00). Steady, predictable timing is essential for stable trough levels.
- Take consistently with respect to food — either always with food or always without, but always the same way. Food affects absorption modestly even in the modified microemulsion.
- Avoid grapefruit juice and grapefruit completely. Grapefruit raises cyclosporine levels by 30–50% via CYP3A4 inhibition in the gut wall — even a small daily glass.
- Swallow capsules whole. Do not crush, split or chew.
- Never switch between brands (Conimune ME, Neoral, Sandimmune ME, generic ME) without telling the prescriber and re-checking trough level after 1 week. Despite the “ME” designation, generic-vs-brand differences in absorption are real.
- Check the morning trough BEFORE the morning dose — never after. Drawing the sample post-dose gives a misleadingly high reading.
- Tell every prescriber, dentist and pharmacist that you take cyclosporine — the interaction surface is huge and even short courses of an antibiotic, antifungal or anti-epileptic can change levels significantly.
- Daily SPF 50 sun protection from day one. Long-term cyclosporine markedly raises non-melanoma skin cancer risk — sunscreen, sun-protective clothing, avoiding sunbeds and annual dermatology review all reduce that risk.
- Avoid live vaccines during therapy and for 3 months after. Inactivated vaccines (annual flu, pneumococcal, COVID-19, recombinant Shingrix) are fine and recommended.
- Drink enough water — mild chronic dehydration worsens cyclosporine nephrotoxicity.
Monitoring Schedule
Cyclosporine therapy is impossible without regular monitoring. Skipping checks is the single most preventable cause of avoidable harm.
| Test | Frequentie | Action threshold |
|---|---|---|
| Whole-blood trough cyclosporine level | Weekly × 4, then every 2 weeks × 4, then monthly | Adjust dose to indication-specific target |
| Serumcreatinine + eGFR | Same schedule as trough | Rise > 30% from baseline = dose reduction or hold |
| Blood pressure (home or clinic) | Weekly × 4, then monthly | Sustained > 140/90 = add or increase antihypertensive (CCBs first-line) |
| Serum potassium and magnesium | Same schedule as trough | High K+ or low Mg2+: dietary advice, supplementation |
| Fasting lipids | Baseline, then every 3 months | Elevated cholesterol/triglycerides: dietary advice; statin (with care) |
| Fasting glucose / HbA1c | Baseline, then every 3 months | New-onset diabetes management as standard |
| LFTs (ALT, AST, bilirubin) | Baseline, then monthly × 6, then quarterly | Hepatocellular pattern > 3× ULN = hold and review |
| Skin examination | Baseline; annual dermatology review during long-term use | Any new pigmented or non-healing lesion — biopsy |
| Dental review | Baseline + every 6 months | Gum hyperplasia — aggressive oral hygiene + periodontal review |
Side Effects of Conimune ME
Side effects are dose-dependent and very common at therapeutic doses. The most clinically important are nephrotoxicity, hypertension and infection.
Common (> 10%):
- Nephrotoxicity — rise in serum creatinine, fall in eGFR. Reversible at lower doses if caught early; chronic interstitial fibrosis with prolonged high-dose use.
- Hypertensie — develops in 30–50% of patients within weeks; CCBs (amlodipine, nifedipine) are first-line because they do not interact with cyclosporine.
- Tremor — fine resting tremor of hands; usually mild and dose-related.
- Hirsutism — increased facial and body hair growth; cosmetic concern especially for women.
- Gum hyperplasia — soft, painless overgrowth of gum tissue; minimised by aggressive oral hygiene; surgical reduction if severe.
- Hyperkaliëmie
- Hypomagnesaemia
- Hyperlipidaemia
- Hoofdpijn
- Nausea, abdominal discomfort, diarrhoea
- Increased susceptibility to infection — especially viral (CMV, EBV, BK virus), reactivation of TB and herpes zoster
Uncommon to rare but serious:
- Severe nephrotoxicity with chronic interstitial fibrosis
- Posterior reversible encephalopathy syndrome (PRES) — severe headache, confusion, seizure, visual disturbance, MRI findings; medical emergency
- Thrombotic microangiopathy — haemolysis, thrombocytopenia, AKI
- Disseminated severe infection (TB, opportunistic fungal, atypical mycobacterial, severe viral)
- Lymphoma — small but real increase in non-Hodgkin lymphoma risk; particularly EBV-driven post-transplant lymphoproliferative disorder (PTLD)
- Non-melanoma skin cancer — risk rises sharply with cumulative dose and sun exposure
- Hepatotoxiciteit — cholestatic pattern usually; reversible on dose reduction
- Severe hypertension or hypertensive emergency
- Anaphylaxis to the IV vehicle (Cremophor EL) — not relevant for oral capsules but flag for record
Waarschuwingen en voorzorgsmaatregelen
- Pre-existing renal impairment — relative contraindication; if essential, use lower dose with closer monitoring.
- Uncontrolled hypertension — control BP before starting; expect further rise on therapy.
- Active or untreated infection — defer cyclosporine if possible until cleared.
- Latent TB, hepatitis B/C — screen before starting; consider isoniazid prophylaxis if latent TB; specialist input for HBV/HCV.
- Live vaccines — contraindicated during therapy and for 3 months after. Plan all live vaccines (MMR, varicella, yellow fever, BCG, live Zostavax) before starting; recombinant Shingrix can be given during therapy.
- Sun exposure — daily SPF 50, sun-protective clothing, avoid sunbeds.
- Zwangerschap — cyclosporine is one of the few immunosuppressants that is generally considered compatible with pregnancy when essential for maternal disease (transplant, severe autoimmune). It crosses the placenta but is not strongly teratogenic. Doses may need adjustment as pregnancy progresses.
- Borstvoeding — passes into breast milk in measurable amounts; many sources advise against breastfeeding on cyclosporine, though the WHO and several recent expert reviews now consider it acceptable with infant monitoring.
- Children — used in paediatric transplant and severe nephrotic syndrome; weight-based dosing; growth monitoring.
- Elderly — lower doses; closer monitoring of renal function and BP; greater interaction risk from polypharmacy.
- Surgery and anaesthesia — tell the anaesthetist; some anaesthetic drugs raise cyclosporine levels; perioperative renal function may worsen.
Contraindications — Who Should NOT Take Conimune ME
- Known hypersensitivity to cyclosporine or any capsule excipient
- Concurrent treatment with potassium-sparing diuretics (or potassium supplements) where significant hyperkalaemia is anticipated
- Severe uncontrolled infection
- Severe uncontrolled hypertension (relative)
- Significantly impaired baseline renal function (relative; balance against indication)
- Recent live vaccine
- Active malignancy (other than the indication being treated, e.g. transplant)
- Pregnancy — only when benefits outweigh risks (relative; not absolute)
Drug Interactions — the Big Surface
Cyclosporine is metabolised by CYP3A4 and is a substrate of P-glycoprotein. Hundreds of drugs interact with it. The most clinically important are listed below; any new prescription, OTC product, or herbal remedy should be checked for interaction before starting.
| Combineren met | Effect | Wat te doen |
|---|---|---|
| Statines (especially simvastatin, lovastatin, atorvastatin) | Major rhabdomyolysis risk — cyclosporine dramatically raises statin levels | Avoid simvastatin and lovastatin entirely. Use pravastatin (no CYP3A4 metabolism), fluvastatin, or low-dose atorvastatin (max 10 mg). Monitor CK at baseline and as symptoms warrant. |
| NSAID's (ibuprofen, diclofenac, naproxen) | Additive nephrotoxicity, hypertension, hyperkalaemia | Avoid combination if possible; if essential, use lowest dose for shortest duration; monitor renal function closely. |
| Grapefruit juice and grapefruit | Raises cyclosporine levels 30–50% via gut CYP3A4 inhibition | Avoid completely. Tell patients explicitly — many overlook this. |
| Azole antifungals (ketoconazole, fluconazole, itraconazole, voriconazole) | Markedly raise cyclosporine levels | If antifungal is essential, reduce cyclosporine dose 25–75% and check trough within 3–5 days. Use topical antifungals where possible. |
| Macrolide antibiotics (erythromycin, clarithromycin, azithromycin to lesser extent) | Raise cyclosporine levels | Use alternative antibiotic where possible; if macrolide essential, recheck trough within a few days. |
| Calcium-channel blockers (verapamil, diltiazem strongly; amlodipine and nifedipine weakly) | Raise cyclosporine levels (verapamil/diltiazem); amlodipine and nifedipine cause minimal change — preferred for cyclosporine-induced hypertension | Use amlodipine or nifedipine as first-line antihypertensive in cyclosporine-induced HTN; avoid verapamil/diltiazem. |
| Rifampicin, phenytoin, carbamazepine, phenobarbital, St John's wort | Lower cyclosporine levels — risk of transplant rejection or autoimmune flare | Consider alternative; if essential, increase cyclosporine dose 1.5–3× with frequent trough checks. |
| Aminoglycosides, amphotericin B, vancomycin, ciprofloxacin | Additive nephrotoxicity | Use alternatives where possible; close renal monitoring if combined. |
| Kaliumsparende diuretica (spironolactone, eplerenone, amiloride) and potassium supplements | Hyperkalaemia — can be severe | Avoid combination unless specifically indicated and monitored. |
| Methotrexate, azathioprine, biologics | Additive immunosuppression and infection risk | Specialist combinations; consider PCP and antiviral prophylaxis. |
| Live vaccines | Risk of disseminated vaccine-strain infection | Contraindicated; use inactivated alternatives. |
Bewaaradvies
- Bewaren bij kamertemperatuur, 15–30°C, in the original blister or bottle. Keep below 30°C.
- Protect from extreme cold (do not freeze) and high humidity.
- Capsules may have a faint olive-oil-like smell — this is normal for the modified microemulsion formulation.
- Keep in the original blister until use.
- Keep out of reach of children.
- Do not use after the expiry date on the pack.
- Return unused capsules to a pharmacy for disposal.
Gerelateerde alternatieven op MedsBase
Other medications used in anti-inflammatory and autoimmune care stocked alongside this product:
- Barinat (baricitinib 2 / 4 mg) — JAK1/2 inhibitor for RA
- Tofe (tofacitinib 5 mg) — JAK1/3 inhibitor for RA, UC, PsA
- Azoran (azathioprine 50 mg) — classic immunosuppressant DMARD
- Lefuheal (leflunomide) — oral DMARD for rheumatoid arthritis
- Wysolone (prednisolone 5 / 10 / 20 mg) — oral corticosteroid
- Medrol (methylprednisolone 4 / 8 / 16 mg) — oral corticosteroid
- Predniheal (prednisolone) — oral corticosteroid
- Hisone (hydrocortisone) — physiologic replacement steroid
- Budez CR (budesonide) — gut-targeted corticosteroid for Crohn's
- Kenacort (triamcinolone) — systemic corticosteroid
Explore the full Anti-Inflammatory & Autoimmune Care category.
Veelgestelde vragen
What does the “ME” in Conimune ME mean?
ME stands for Modified microEmulsion — a self-emulsifying lipid-based formulation that gives much more reliable cyclosporine absorption than the original Sandimmune oil-based formulation. Modified microemulsion (Neoral / Sandimmune ME / Conimune ME) absorbs predictably, regardless of bile flow or food. Note: modified microemulsion is NOT bioequivalent to original Sandimmune — switching between them requires re-checking trough level and may need a dose adjustment.
Why does Conimune ME need a blood test all the time?
Cyclosporine has a narrow therapeutic window — the dose that works for transplant rejection prevention or autoimmune control is close to the dose that causes nephrotoxicity. Whole-blood trough cyclosporine level is the only reliable way to keep you in the right range. Sample BEFORE the morning dose, ideally 12 hours after the last dose. Drawing the sample after the dose gives a misleading peak result.
Why must I avoid grapefruit on Conimune ME?
Grapefruit juice (and the fruit itself) inhibits CYP3A4 enzymes in the gut wall that normally break down cyclosporine before it reaches the bloodstream. Even one small daily glass can raise cyclosporine levels by 30–50% — pushing you into the toxicity zone (raised creatinine, hypertension, tremor, hyperkalaemia). The effect lasts up to 72 hours after the last grapefruit exposure. Avoid completely.
Can I take ibuprofen or other painkillers on Conimune ME?
NSAIDs (ibuprofen, diclofenac, naproxen) ADD to cyclosporine's renal toxicity, hypertension and hyperkalaemia. Avoid them where possible. Paracetamol is safe at standard adult doses (1 g four times daily max), and topical NSAIDs (diclofenac gel) carry far lower systemic absorption. If you need an NSAID for a specific reason, discuss with your prescriber and arrange close renal monitoring during the course.
My gums are getting overgrown on Conimune ME — what can I do?
Gum (gingival) hyperplasia is a common cyclosporine side effect — usually painless, soft overgrowth of gum tissue, especially around teeth with poor oral hygiene. Aggressive oral hygiene (brushing twice daily, flossing, regular professional cleaning every 3–6 months) reduces but doesn't eliminate it. Severe overgrowth may need surgical reduction (gingivectomy) by a periodontist. Switching to tacrolimus (which doesn't cause this) is sometimes considered. Tell your dentist you take cyclosporine.
Why am I more prone to skin cancer on Conimune ME?
Cyclosporine impairs T-cell-mediated tumour surveillance, particularly in skin exposed to UV. After 5+ years of treatment, the risk of squamous and basal cell skin cancers is several times higher than baseline; melanoma risk is also raised modestly. Daily SPF 50 sunscreen, sun-protective clothing, avoiding sunbeds and annual full-skin dermatology review meaningfully reduce that risk. Any new pigmented or non-healing skin lesion should be biopsied early.
Can I become pregnant on Conimune ME?
Yes — cyclosporine is one of the few immunosuppressants generally considered compatible with pregnancy. It is widely used in transplant recipients who become pregnant. The drug crosses the placenta but is not strongly teratogenic; the main maternal concerns are hypertension and gestational diabetes (more common on cyclosporine). Doses may need adjustment as plasma volume rises through pregnancy. Discuss with your transplant or autoimmune team at least 3 months before planned conception. Effective contraception is not strictly required but shared decision-making is essential.
Can I have live vaccines on Conimune ME?
No. Live vaccines — MMR, varicella, yellow fever, BCG, live nasal flu, live Zostavax shingles vaccine — are contraindicated during cyclosporine therapy and for 3 months after stopping. Plan all live vaccines before starting where possible. Inactivated vaccines are fine and recommended: annual flu jab, pneumococcal, COVID-19, recombinant Shingrix (NOT live Zostavax), HPV. Recombinant Shingrix is the correct shingles vaccine for immunosuppressed patients.
What do I do if I miss a dose?
If less than 6 hours late, take it as soon as you remember. If more than 6 hours late, skip that dose and take the next dose at the normal time. Niet verdubbelen. Tell the prescriber if you have missed multiple doses — trough level will need to be re-checked sooner than scheduled. In transplant patients, repeated missed doses risk rejection.
Waarom bestellen bij MedsBase
Conimune ME is supplied through a WHO-GMP certified manufacturer with full COA documentation. We ship worldwide in plain, discreet packaging, and every order is covered by our Reshipment Assurance Policy. Uw betalingsbeschrijving bij betaling per kaart toont de gereguleerde betalingsverwerker (een gereguleerde kaartbetalingverwerker), nooit “MedsBase” of een medicijnnaam.
Other Anti-Inflammatory & Autoimmune Medications
If Conimune ME does not suit your situation, the following options are available in this category:
- Azoran (Azathioprine 50 mg) — purine antimetabolite
- Lefuheal (Leflunomide 10/20 mg) — pyrimidine synthesis inhibitor
- Barinat (Baricitinib 2/4 mg) — selective JAK1/JAK2 inhibitor
- Tofe (Tofacitinib 5 mg) — pan-JAK inhibitor
- Wysolone (Prednisolone 5/10/20 mg) — bridging corticosteroid
More options in Anti Inflammatory & Autoimmune Care
Gerangschikt op recente bestelvolumes van MedsBase — wat andere klanten in deze categorie kiezen.
| Sterkte | 25 mg |
|---|---|
| Hoeveelheid | 30 Capsule/s, 60 Capsule/s, 90 Capsule/s, 180 Capsule/s |
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