Cyclosporine is an immunosuppressive drug used to treat immune-mediated diseases, especially blood and skin conditions (ex. atopic dermatitis).
What is this drug?
An immunosuppressive agent
Given by mouth
Reasons for prescribing:
Used to treat immune-mediated diseases (ex. immune-mediated hemolytic anemia, discoid lupus erythemathosus in the dog)
May also be used to treat 'dry eye' (or keratoconjunctivitis sicca/KCS), perineal fistualas, asthma in the cat
Used to prevent rejection of transplanted organs
What pets should not take this medication?
Pets weighing less than 4 pounds or those less than 6 months of age.
Use with caution in pets with liver or kidney disease
Pets with malignant neoplasia
If your pet has had an allergic reaction to cyclosporine
Read and follow the label carefully.
Give this medication without food. Give this medication 1 hour before a meal or 2 hours after. The dose may be tapered by decreasing the frequency of dosing to every other day or 2 times per week until a minimum frequency is achieved that will maintain the desired therapeutic effect.
Cyclosporine tastes bitter. Do not open capsules and give contents by sprinkling on food.
Give this medication for as long as veterinarian directs. Do not skip doses or stop giving the medication without consulting your veterinarian.
Your veterinarian may want to monitor the effects of cyclosporine by performing occasional blood tests.
What if a dose is missed?
If a dose is missed, give it as soon as you can, but do not give more than one dose/day. If it is time already for the next dose, skip the missed dose and go back to the normal schedule. Do not give two doses at the same time.
What to tell/ask a veterinarian before giving medication?
Talk to your veterinarian about:
When will your pet need to be rechecked
What tests may need to be performed prior to and during treatment with this drug
What are the risks and benefits of using this drug
Tell your veterinarian about:
If your pet has experienced side-effects on other drugs/products
If your pet has experienced digestive upset now or ever
If your pet has experienced liver or kidney disease now or ever
If your pet has experienced any other medical problems or allergies now or ever
All medicines and supplements that you are giving your pet or plan to give your pet, including those you can get without a prescription. Your veterinarian may want to check that all of your pet's medicines can be given together.
If your pet is pregnant, nursing or if you plan to breed your pet
Storage and Warnings:
There are two brands of the oral liquid but they are not the same strength, therefore cannot be subsituted for the other.
Shake oral liquids before using. After opening an oral liquid, use it within 2 months.
If capsules come in a foil blister pack, do not open the pack until ready to use.
Store at room temperature away from heat and direct sunlight. Protect from freezing and do not refrigerate.
Long-term storage in some plastics can cause inactivation of the drug.
Keep this and all medication out of reach of children and pets.
Pregnant owners should avoid handling this drug.
Call your physician immediately if you accidentally take this product.
Potential side effects:
If your pet experiences side effects related to the digestive system (loss of appetite, vomiting, diarrhea), contact your veterinarian. Giving the medication with a small amount of food may be necessary.
Other side effects may include ear or urinary infections, jaundice, or lethargy.
More rarely, some pets experience overgrowth of the gums, muscle cramps and increased hair growth. Contact your veterinarian if you notice any of the above signs.
High doses may cause immune system suppression which may cause your pet to be more susceptible to infection. Contact your veterinarian if your pet has a fever (>103°F), painful urination, fatigue, sneezing, coughing or runny eyes.
Can this drug be given with other drugs?
Yes, but possible interactions may occur with vitamins and supplements, allopurinol, aminoglycosides, amiodarone, amphotericin, androgens, azole antifungals, calcium channel blockers, cimetidine, colchicines, corticosteroids, digoxin, eythromycin, etoposide, metoclopramide, omeprazole, phenobarbital, phenytoin, probucol, rifampin, terbinafine, trimethoprim sulfa, and some vaccines.
Make sure your veterinarian knows all of the medicines and supplements you are giving your pet or plan to give your pet, including those you can get without a prescription. Do not start, stop or change the dosage of any medicine, including this one, before checking with your veterinarian.
If your pet experiences any unusual reactions when taking multiple medications, contact your veterinarian.
Contact your veterinarian immediately if your pet receives more than the prescribed amount.
What else should I know?
Notify your veterinarian if your animal's condition does not improve or worsens despite this treatment.
As with all prescribed medicines, Cylcosporine should only be given to the pet for which it was prescribed.
It should be given only for the condition for which it was prescribed.
(Sandimmune, Neoral, Atopica)
Common Drug Name
Common Brand Names
Sandimmune, Neoral, Atopica
Generic products are available.
Store at room temperature (70-77°F), in a tight, light resistant, childproof container. Protect from freezing and do not refrigerate. If the oral suspension or noncompounded capsules are stored at less than 68°F, they may gel. If this occurs, allow to warm to room temperature. Shake the oral liquid before using. After opening the oral liquid, use it within 2 months. If the capsules come in a foil blister pack, do not open the pack until ready to use.
Cyclosporine suppresses the immune system and is used to treat immune-mediated diseases, especially those involving the blood or skin. It may also be used in the treatment of anal fistulas in dogs, asthma in cats, and to prevent rejection of transplanted organs. One brand, Atopica, is approved for use to treat atopy (allergy to inhaled substances.)
Dose and Administration
IMPORTANT: Always follow the dosage instructions provided by your veterinarian. If you have difficulty giving the medication, contact your veterinarian.
Give this medication without food. If side effects related to the digestive system are observed, contact your veterinarian, who may direct you to give the medication with a small amount of food.
Cyclosporine is bitter. Do not open the capsules and attempt to give the contents by sprinkling on the food.
If you miss a dose, give it as soon as you remember. If it is almost time for the next dose, skip the one you missed and go back to the regular schedule. Do not give 2 doses at once.
This medication should only be given to the pet for whom it was prescribed.
Possible Side Effects
May see loss of appetite, vomiting, and diarrhea. More rarely, may see overgrowth of the gums, loss of appetite, muscle cramps, and increased hair growth. Contact your veterinarian if you notice any of the above signs.
At high doses, immune system suppression may occur, making a pet more susceptible to infection. Contact your veterinarian if your pet has a fever (over 103°F), painful urination, tiredness, sneezing, coughing, or runny eyes.
If your pet experiences an allergic reaction to the medication, signs may include facial swelling, hives, scratching, sudden onset of diarrhea, vomiting, shock, seizures, pale gums, cold limbs, or coma. If you observe any of these signs, contact your veterinarian immediately.
Not for use in animals hypersensitive (allergic) to it or other ingredients.
Use with caution in animals with kidney or liver disease.
Do not use in breeding or pregnant animals. If the mother is receiving cyclosporine, place the offspring on milk replacer after they have received the colostrum (first milk immediately after birth).
There are two brands of the oral liquid form (Sandimmune and Neoral). They are not the same strength, so one should not be substituted for the other.
Cyclosporine is inactivated by some plastics. Do not leave the medication in plastic cups or syringes for a long time or it may lose its effectiveness.
Cyclosporine can become toxic if its level in the blood becomes too high. Consult with your veterinarian regarding the physical examinations and laboratory testing necessary prior to and during treatment with cyclosporine.
Drug, Food, and Test Interactions
Consult your veterinarian before using cyclosporine-oral with vitamins and supplements, digoxin, etoposide, and corticosteroids, amiodarone, androgens (testosterone), azole antifungals (ketoconazole, itraconazole), erythromycin, calcium channel blockers (diltiazem), corticosteroids, metoclopramide trimethoprim/sulfa, rifampin, phenobarbital, phenytoin, terbinafine, probucol, omeprazole amino-glycosides (e.g., gentamicin) or amphotericin, vaccines, or modified live vaccines, since interactions may occur.
Signs of Toxicity/Overdose
May see loss of appetite, increased thirst, increased urination, jaundice (yellowing of gums, skin, or eyes), vomiting, or lethargy.
If you know or suspect your pet has had an overdose, or if you observe any of these signs in your pet, contact your veterinarian immediately.
Keep this and all other medications out of the reach of children and pets.
This information may not cover all possible uses, directions, side effects, precautions, allergic reactions, drug interactions, or withdrawal times. Always consult your own veterinarian for specific advice concerning the treatment of your pet.