Cyclosporine - Oral

By Rania Gollakner, BS, DVM, MPH

What is cyclosporine?

Cyclosporine (Atopica®) is an immune-modulating medication, meaning it adjusts the 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 many other immune-mediated conditions.

The use of cyclosporine for conditions other than allergic/atopic dermatitis in dogs or cats is considered off-label. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully.

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. Do not open or break the capsules. Do not rinse the oral syringe between doses. Measure liquid forms carefully. Give this medication exactly how your vet has prescribed it.

"Cyclosporine is given by mouth, in the form of a capsule for dogs and a liquid suspension for cats."

Generally, cats should get this medication with food. Dogs should be given 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, giving the medication with a small amount of food or freezing the capsules prior to administration can help.

CAUTION: Exposure in humans, especially pregnant women, can have consequences, so care must be taken to avoid accidental exposure. Gloves should be worn when handling the medication. 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?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. For some conditions, if it is close to the time for the next dose, it is okay to skip the dose you missed and give it at the next scheduled time and then return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects from cyclosporine?

The most common side effects of cyclosporine in dogs and cats are gastrointestinal side effects such as vomiting, diarrhea, and decreased appetite (anorexia). These side effects usually decrease over time.

Other side effects in dogs include urinary tract infections, lethargy, gingival hyperplasia (overgrowth of the gums), and enlarged lymph nodes.

Other side effects in cats include lethargy, hypersalivation (drooling), behavior disorders, conjunctivitis, sneezing/rhinitis, gingivitis (inflammation of the gums), increased hair growth, and increased drinking.

Because cyclosporine suppresses the immune system, increased susceptibility to infection and the development of neoplasia (cancer) are rare but possible. 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?

Some dogs and cats, or those with certain conditions should not use cyclosporine. These include:

• dogs and cats with a history of cancer or hypersensitivity to cyclosporine
• cats infected with feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV)
• dogs and cats younger than six months of age, or weigh less than three pounds (cats) or four pounds (dogs)
• dogs and cats that are breeding, pregnant, or nursing.

Cyclosporine should be used with caution in dogs and cats with kidney disease and/or diabetes. Use cautiously in cats that have not been evaluated for an underlying toxoplasma infection or in cats with active toxoplasma infections. Cyclosporine can also decrease the immune system’s response to vaccinations; therefore, modified live vaccines should be used with caution.

"Cyclosporine can also decrease the immune system’s response to vaccinations; therefore, modified live vaccines should be used with caution."

Are there any drug interactions I should be aware of?

Cyclosporine should be used with caution when given with other drugs that are processed by the body in the same way, as it can increase or decrease the blood levels of cyclosporine. Many drugs are processed the same way in the body such as azole antifungals, many types of antibiotics, gastrointestinal drugs, and others. Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Monitor your pet for side effects, increased thirst or urination, jaundice (yellowing of the skin and mucous membranes), signs of infection, or lethargy. Monitor for the effectiveness of therapy. 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 capsules should be stored in their original unit-dose container at controlled temperatures between 59 and 77°F (15-25°C). The liquid suspension should also be stored at room temperature and, once opened, should be used within eight 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 negative reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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