Guide To Cyclosporine

May 11, 2023

While the immune system normally protects the body from threats, such as viruses and bacteria, it can sometimes become unregulated. When left unchecked, this can lead to serious health consequences. This includes chronic inflammation or organ damage. Cyclosporine, an immunosuppressant, is often used to prevent or treat an unregulated immune system.

Patients will receive cyclosporine tablets before or after organ transplants. In some cases, a cyclosporine oral solution is used. It can be used as prescription eye drops for some eye conditions. This medication is also a treatment for arthritis and many other health issues. Of course, patients need to know about how cyclosporine pills work, as well as possible side effects and interactions first.

How It Works

Cyclosporine suppresses the immune system by reducing an enzyme known as calcineurin. This enzyme is a major part of the immune system because it plays an important role in creating T-cells. These are a type of white blood cell. T-cells respond to foreign cells within the body, which are recognized as threats, by causing damage to them. During organ transplants, T-cells may mistakenly attack and cause damage to an organ because it recognizes the organ's cells as a foreign threat. In addition to this, T-cells also play a role in inflammation because they can activate other types of white blood cells responsible for causing inflammation.

An overactive immune system, or one that does not function correctly, can result in autoimmune disorders and health conditions that involve chronic inflammation. As this medication reduces calcineurin, the enzyme that regulates T-cells, it can help prevent many of these health conditions. For this reason, this medication is also known as a calcineurin inhibitor.

Uses And Benefits

Cyclosporine is beneficial as a treatment in many different conditions that involve immune dysfunction. The most common condition it is prescribed for is graft rejection. This is also known as transplant rejection. In this disorder, the immune system of an organ transplant recipient rejects a donor's organ. This happens because the recipient's immune system recognizes cells within the donated organ as being foreign to the body. Cyclosporine helps prevent this from happening by suppressing the recipient's immune system and its response.

Similarly, this medication is often used in the treatment of graft-versus-host disease. This is a condition where white blood cells from a donor's transplanted bone marrow or stem cells attack cells within a recipient's body. Cyclosporine is also beneficial in many different inflammatory conditions where an immune disorder causes inflammation of the skin, joints, eyes, or other parts of the body. Some of the more common examples are psoriasis, rheumatoid arthritis, and dry eye syndrome.

Potential Side Effects

Cyclosporine can cause mild to severe side effects. They can differ based on how it is administered. Common side effects of the oral and injectable forms include high blood pressure, low magnesium levels, tremors, gum overgrowth, excessive hair growth, and blood clots within the kidneys. Nephrotoxicity, when there are excess toxins within the kidneys, is a common side effect of this medication when it is taken in large doses or over long periods. Less common side effects include liver damage, kidney damage, and lung problems. Although they are not as common, they are more serious.

Vasoconstriction, which is the narrowing of blood vessels, is one side effect that can lead to many of these other damaging effects. As an eyedrop solution, cyclosporine can cause side effects relating to the eyes. Examples include burning, itching, dryness, or redness. Since it is an immunosuppressant, individuals taking this drug may also be at an increased risk of infections, regardless of which form they are taking.

Precautions To Remember

Seniors, as well as individuals with pre-existing kidney disease or hypertension, should consult their doctor about taking cyclosporine. This is because they may be at an increased risk of kidney damage. Those taking creatine supplements may also be at risk because cyclosporine can cause increased creatinine levels in the blood, which can overburden the kidneys. When taking this medication, individuals should not drink alcohol. Doing so can result in both liver and kidney damage.

Those who have any form of liver disease are not only at risk of liver damage when taking cyclosporine, but other complications as well. Impaired liver function can slow the time it takes for the body to metabolize this medication. This can then lead to excessive amounts of the medication within the liver and body. Also, as cyclosporine is an immunosuppressant, individuals with any active infections should avoid taking it as well. Those taking this medication should also avoid others who may be sick with viral, bacterial, or fungal infections for the same reason.

Potential Medication Interactions

Cyclosporine can inhibit CYP3A4. This is an enzyme responsible for removing toxins and drugs from the body. This means that taking it with certain medications can result in increased concentrations of these drugs or cyclosporine within the body that can be dangerous. The kidneys are highly susceptible because their excretion rate of harmful substances is decreased. This can cause toxins and metabolites to build in these organs. Other medications that cyclosporine has been known to interact with include antivirals, antibiotics, steroids, blood pressure medications, and cholesterol drugs. Examples include cidofovir, neomycin, mifepristone, bosentan, and atorvastatin.

Taking high doses of methylprednisolone in combination with cyclosporine has been linked to neurotoxicity. This can result in convulsive seizures in some individuals. As cyclosporine is known to cause reductions in magnesium, other magnesium-reducing medications may also cause serious interactions when taken with it. It is important that patients speak to their doctor before taking this drug. This will help prevent potential medication interactions.

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