Health Boards
What is Ciclosporine and how does it work?
Like Penicillin, Ciclosporine was discovered as a substance produced by fungi.
It was found to suppress the immune system and was developed for suppressing the immune system of transplant patients to prevent them rejecting their transplanted organs.
It was subsequently found to benefit patients with a range of diseases and conditions caused by immune reactions.
Why suppress the immune system?
There are several reasons:
In "auto-immune" diseases, the immune system attacks the body itself.
These diseases can affect just one organ - such as the heart, liver or skin - or a number of organs.
There also diseases in which the body's immune system becomes over active, letting a disease persist or even get worse.
Suppressing the immune system can then be helpful.
After transplant surgery, the immune systemhas to be suppressed to stop the transplanted organ being rejected. Most patients who have had a kidney or heart transplant take Ciclosporine as part of the combination of drugs used to suppress their immune system.
Which skin conditions are treated with Ciclosporine?
Ciclosporine is prescribed for conditions in which the immune system is to active.
It is only licensed to treat Psoriasis & Eczema (UK, could vary with country).
However, drugs are often used for conditions not included in the original license application.
In the case of Ciclosporine, these include bullous pemphigoid, pyoderma, gangrenosum, chronic actinic dermatitis and cutaneous vasculitis.
Will Ciclosporine cure my skin condition?
None of the skin conditions for which Ciclosporine is used are "cured" by this treatment.
Usually, a gradual improvement is seen, starting in the first few weeks of treatment, and then Ciclosporine will be continued to keep the skin problem under control.
What dose should I take?
Your Doctor/Consultant will advise you here, as the dose prescribed depends partly on your body weight.
Ciclosporine is usually taken in capsule form twice daily.
The capsules are available in 4 strengths: 10, 25, 50 or 100mg.
Ciclosporine is also available as a liquid.
The total dose taken is usually within the range of 2-5mg per kilo of body weight per day.
NB: Grapefruit or grapefruit juice should not be taken for an hour each side of the dose, as it grossly affects absorbtion rate.
Also note that different makes of Ciclosporine can be absorbed differently by the body, so it is recommended to always use the same medication from the same source. If you change medication however, then it is possible that you will need to have a Ciclosporine level blood test performed.
What are the possible side effects of Ciclosporine?
In some people Ciclosporine can cause sickness (nausea), diarrhoea, gum overgrowth, tiredness and excessive hair growth. It can also produce a mild tremor.
Sometimes a mild burning sensation of the hands and feet can occur in early treatment.
If Ciclosporine is used in a high dose it can affect the liver.
The side effects tend to be reduced or get better if the dose is reduced.
Are there any long term side effects of Ciclosporine?
The long term side effects include reduced function of the kidneys and raised blood pressure.
If you suffer consistently with high blood pressure, you will probably not be considered for this treatment.
The dose of Ciclosporine has to be reduced or stopped if there is a significant rise in blood pressure or effects on the kidney function.
Provided the treatment is closely monitered and appropriate adjustments are made the side effects can be reversed.
Ciclosporine can also cause increased levels of lipidsin the blood (ie: cholesterol).
Taking Ciclosporine for a number of years increases your risk of getting some types of Cancer.
This includes skin cancer, and patients should limit their sun exposure.
If you are concerned about this, you should consult with your health professional.
How will I be monitered for side effects?
As Ciclosporine can have adverse effects on the kidneys & blood pressure, your doctor will arrange for you to have regular tests of blood & urine, and checks on your blood pressure.
These tests will at first be frequent, then less often once the dose has been stabilised.
You may be asked to keep a record of your treatment in a log along with your test results. Take this with you on any follow up appointments.
You must not take Ciclosporine unless you are being closely monitored.
Does Ciclosporine effect fertility or pregnancy?
It is best not to take Ciclosporine when pregnant, however it is possible.
If you are planning a family, or if you become pregnant during treatment, you should consult your health professional asap.
You should not breast feed while taking Ciclosporine.
May I drink alcohol while on Ciclosporine?
There is no evidence or reason for you to avoid alcohol while taking Ciclosporine.
Can I take other medicines while taking Ciclosporine?
Ciclosporine may be prescribed in combination with other drugs.
However, some other drugs interact with it and you should always tell any doctor treating you that you are taking Ciclosporine.
You should not take over-the-counter medications without discussing this first with your doctor or pharmacist.
However, there are many drugs that can be taken with Ciclosporine.
Drugs that may interact with Ciclosporine include:
Aspirin & non-steroidal anti-inflammatory drugs (NSAIDs) ie: ibrufen & diclofenac
Antibiotics: erythromycin, clarithromicin, trimethoprim, ciprofloxacin, rimfampicin,
doxycycline.
Antifungals: fluconazole, itraconazole, ketoconazole & amphotericin.
Blood pressure treatments: ACE inhibitors, beta-blockers & calcium channel blockers.
Hormones: oral contraceptives & corticosteroids.
Digoxin
This is not by any means an exhaustive list and you should always inform any relevant health professionals that you are taking Ciclosporine.
Can I have immunisation injections while taking Ciclosporine?
You should avoid immunisation injections with any LIVE vaccines, such as Polio & Rubella (German measles).
Flu injections & Pneumovax are safe and recommended.
Where can I find out more about Ciclosporine?
If you would like to find out more about Ciclosporine, or have any concerns during or prior to treatment, your first point of contact should be your healthcare professional or pharmacist.
Any individual case can be different and this information is just a guide for anyone wanting to know the basics of Ciclosporine.
Information sourced from British Association of Dermatologists.
Posts from this thread have been split to: [split] Ciclosporine
Like Penicillin, Ciclosporine was discovered as a substance produced by fungi.
It was found to suppress the immune system and was developed for suppressing the immune system of transplant patients to prevent them rejecting their transplanted organs.
It was subsequently found to benefit patients with a range of diseases and conditions caused by immune reactions.
Why suppress the immune system?
There are several reasons:
In "auto-immune" diseases, the immune system attacks the body itself.
These diseases can affect just one organ - such as the heart, liver or skin - or a number of organs.
There also diseases in which the body's immune system becomes over active, letting a disease persist or even get worse.
Suppressing the immune system can then be helpful.
After transplant surgery, the immune systemhas to be suppressed to stop the transplanted organ being rejected. Most patients who have had a kidney or heart transplant take Ciclosporine as part of the combination of drugs used to suppress their immune system.
Which skin conditions are treated with Ciclosporine?
Ciclosporine is prescribed for conditions in which the immune system is to active.
It is only licensed to treat Psoriasis & Eczema (UK, could vary with country).
However, drugs are often used for conditions not included in the original license application.
In the case of Ciclosporine, these include bullous pemphigoid, pyoderma, gangrenosum, chronic actinic dermatitis and cutaneous vasculitis.
Will Ciclosporine cure my skin condition?
None of the skin conditions for which Ciclosporine is used are "cured" by this treatment.
Usually, a gradual improvement is seen, starting in the first few weeks of treatment, and then Ciclosporine will be continued to keep the skin problem under control.
What dose should I take?
Your Doctor/Consultant will advise you here, as the dose prescribed depends partly on your body weight.
Ciclosporine is usually taken in capsule form twice daily.
The capsules are available in 4 strengths: 10, 25, 50 or 100mg.
Ciclosporine is also available as a liquid.
The total dose taken is usually within the range of 2-5mg per kilo of body weight per day.
NB: Grapefruit or grapefruit juice should not be taken for an hour each side of the dose, as it grossly affects absorbtion rate.
Also note that different makes of Ciclosporine can be absorbed differently by the body, so it is recommended to always use the same medication from the same source. If you change medication however, then it is possible that you will need to have a Ciclosporine level blood test performed.
What are the possible side effects of Ciclosporine?
In some people Ciclosporine can cause sickness (nausea), diarrhoea, gum overgrowth, tiredness and excessive hair growth. It can also produce a mild tremor.
Sometimes a mild burning sensation of the hands and feet can occur in early treatment.
If Ciclosporine is used in a high dose it can affect the liver.
The side effects tend to be reduced or get better if the dose is reduced.
Are there any long term side effects of Ciclosporine?
The long term side effects include reduced function of the kidneys and raised blood pressure.
If you suffer consistently with high blood pressure, you will probably not be considered for this treatment.
The dose of Ciclosporine has to be reduced or stopped if there is a significant rise in blood pressure or effects on the kidney function.
Provided the treatment is closely monitered and appropriate adjustments are made the side effects can be reversed.
Ciclosporine can also cause increased levels of lipidsin the blood (ie: cholesterol).
Taking Ciclosporine for a number of years increases your risk of getting some types of Cancer.
This includes skin cancer, and patients should limit their sun exposure.
If you are concerned about this, you should consult with your health professional.
How will I be monitered for side effects?
As Ciclosporine can have adverse effects on the kidneys & blood pressure, your doctor will arrange for you to have regular tests of blood & urine, and checks on your blood pressure.
These tests will at first be frequent, then less often once the dose has been stabilised.
You may be asked to keep a record of your treatment in a log along with your test results. Take this with you on any follow up appointments.
You must not take Ciclosporine unless you are being closely monitored.
Does Ciclosporine effect fertility or pregnancy?
It is best not to take Ciclosporine when pregnant, however it is possible.
If you are planning a family, or if you become pregnant during treatment, you should consult your health professional asap.
You should not breast feed while taking Ciclosporine.
May I drink alcohol while on Ciclosporine?
There is no evidence or reason for you to avoid alcohol while taking Ciclosporine.
Can I take other medicines while taking Ciclosporine?
Ciclosporine may be prescribed in combination with other drugs.
However, some other drugs interact with it and you should always tell any doctor treating you that you are taking Ciclosporine.
You should not take over-the-counter medications without discussing this first with your doctor or pharmacist.
However, there are many drugs that can be taken with Ciclosporine.
Drugs that may interact with Ciclosporine include:
Aspirin & non-steroidal anti-inflammatory drugs (NSAIDs) ie: ibrufen & diclofenac
Antibiotics: erythromycin, clarithromicin, trimethoprim, ciprofloxacin, rimfampicin,
doxycycline.
Antifungals: fluconazole, itraconazole, ketoconazole & amphotericin.
Blood pressure treatments: ACE inhibitors, beta-blockers & calcium channel blockers.
Hormones: oral contraceptives & corticosteroids.
Digoxin
This is not by any means an exhaustive list and you should always inform any relevant health professionals that you are taking Ciclosporine.
Can I have immunisation injections while taking Ciclosporine?
You should avoid immunisation injections with any LIVE vaccines, such as Polio & Rubella (German measles).
Flu injections & Pneumovax are safe and recommended.
Where can I find out more about Ciclosporine?
If you would like to find out more about Ciclosporine, or have any concerns during or prior to treatment, your first point of contact should be your healthcare professional or pharmacist.
Any individual case can be different and this information is just a guide for anyone wanting to know the basics of Ciclosporine.
Information sourced from British Association of Dermatologists.
Posts from this thread have been split to: [split] Ciclosporine