Cyclosporine is an immunosuppressant medication that works by decreasing response by certain immune cells. In veterinary neurology, it is often prescribed in combination with corticosteroids to treat immune-mediated meningoencephalitis and other immune-related neurological conditions.
Because immune-mediated diseases are typically chronic conditions, cyclosporine is frequently prescribed for long-term use. It may take 4–8 weeks after starting cyclosporine for the medication to reach its full therapeutic effect.
Due to its potential effects on organ function and blood cells, pets receiving cyclosporine should have blood work checked 1–2 months after starting the medications and 3–4 times per year thereafter. This usually includes a CBC and chemistry panel to assess blood cell levels and organ function. In some cases, your neurologist may also recommend measuring cyclosporine blood levels to ensure the dose is both safe and effective.
Dosing
Cyclosporine is given orally twice daily. It is available in both capsule and liquid forms, making it suitable for pets of all sizes. Capsules should not be opened or broken, as this reduces their effectiveness. Cyclosporine is best absorbed on an empty stomach. If gastrointestinal upset occurs, freezing the capsules may help reduce vomiting and diarrhea.
Possible Side Effects
- Gastrointestinal upset:Â Vomiting, diarrhea, or decreased appetite are the most common side effects. These may improve with anti-nausea medications, dose adjustments, or giving the medication frozen or with a small amount food.
- Overgrowth of gum tissue (gingival hyperplasia):Â Usually a cosmetic issue, but in some cases may interfere with eating. The gum tissue may or may not shrink back after the medication is discontinued.
- Excessive hair growth:Â Most noticeable on the paws. This is cosmetic only and not harmful.
- Opportunistic infections:Â Because of immune suppression, ear infections and urinary tract infections may occur more frequently. Routine ear exams and urine checks may be recommended.
- Increased cancer risk:Â This is rare but can be seen with long-term use.
Additional Information
Cyclosporine can be combined with the antifungal medication, ketoconazole, which slows its breakdown in the body. This can reduce the cyclosporine dose needed and may help lower costs. Your neurologist will let you know if this is a good option for your pet.