Cyclosporine Oral

What is cyclosporine?

Cyclosporine (Atopica®) is an immune-modulating medication, which means it adjusts the body’s immune response. It is used to treat immune-mediated diseases, such as atopic dermatitis (skin allergies), in cats and dogs. Cyclosporine works by acting on the immune cells involved in an allergic reaction and reduces inflammation and itching associated with allergies. Cyclosporine is also used to treat other immune-mediated conditions.

The use of cyclosporine for conditions other than allergic/atopic dermatitis in dogs or cats is considered off-label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet cyclosporine?

• Cyclosporine is given by mouth, in the form of a capsule for dogs and a liquid suspension for cats. Measure liquid forms carefully.
• Do not open or break the capsules.
• Do not rinse the oral syringe between doses.
• Give this medication exactly how your vet has prescribed it.
• Cats usually should get this medication with food.
• Dogs usually should get the capsules on an empty stomach; wait for one to two hours before feeding your dog.
• If your dog vomits after receiving the medication on an empty stomach, try giving the medication with a small amount of food or freezing the capsules prior to administration.

Cyclosporine is considered a hazardous drug, so it is essential avoid accidental exposure. Wear gloves when handling the medication and do not handle if you are pregnant or nursing. If your pet vomits after giving this drug, wear gloves while cleaning up. Depending on the condition being treated, this medication can take up to six weeks before full effects are noted, but gradual improvements are usually noticeable throughout the treatment.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then wait the recommended time for the next dose, as prescribed by your veterinarian. For some conditions, if it is close to the time for the next dose, you can skip the dose you missed, give it at the next scheduled time, and then return to the regular dosing schedule. Never give the pet two doses at once.

Are there any potential side effects from cyclosporine?

Cyclosporine may cause the following side effects in dogs and cats:

• Gastrointestinal effects such as vomiting, diarrhea, and decreased appetite (anorexia)
• Increased susceptibility to infection (rare)
• Development of cancers (rare)

Cyclosporine may cause the following side effects in dogs:

• Urinary tract infection
• Lethargy
• Gingival hyperplasia (overgrowth of the gums)
• Enlarged lymph nodes

Cyclosporine may cause the following side effects in cats:

• Lethargy
• Hypersalivation (drooling)
• Behavior disorders
• Conjunctivitis
• Sneezing/rhinitis
• Gingivitis (inflammation of the gums)
• Increased hair growth
• Increased drinking

Cyclosporine suppresses the immune system, so increased susceptibility to infection and the development of neoplasia (cancer) are rare but possible. Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short- to moderate-acting medication should stop working within one to three days, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE cyclosporine in:

• Animals with a history of cancer or hypersensitivity to cyclosporine
• Animals that are breeding, pregnant, or nursing
• Animals younger than six months of age
• Cats that weigh less than 3 pounds (1.4 kg)
• Dogs that weigh less than 4 pounds (1.8 kg)

USE WITH CAUTION in:

• Animals with kidney disease and/or diabetes
• Cats that have not been evaluated for underlying toxoplasma infection
• Cats with active toxoplasma infections

Are there any drug interactions I should be aware of? 

Several medications should be used with caution when given with cyclosporine, including:

• Azole antifungals
• Many types of antibiotics
• Gastrointestinal drugs
• Live vaccines

Cyclosporine can decrease the immune system’s response to vaccinations, so modified live vaccines should be used with caution if a pet is taking cyclosporine.

Be sure to tell your veterinarian about any medications (including vitamins, supplements or herbal therapies) that your pet is taking before starting any treatment.

Is any monitoring needed with this medication?

• At home, monitor for any side effects such as those noted above, as well as increased thirst or urination, jaundice (yellowing of the skin and mucous membranes), signs of infection, or lethargy. If any occur, stop using the medication and contact your veterinarian.
• Your veterinarian will let you know when and how they want to reassess your pet to ensure the medication is working and not causing side effects.
• Your veterinarian may also recommend certain blood or urine tests to monitor for appropriate drug levels, underlying infections, and/or organ function problems.

How do I store cyclosporine?

• Cyclosporine should be stored in its original container at controlled temperatures between 59°F and 77°F (15°C-25°C).
• Once opened, cyclosporine liquid suspension should be used within 8 weeks for the 5mL container and 11 weeks for the 17mL container.

What should I do in case of an emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms. If human exposure to the medication occurs, wash the area thoroughly.