What is Ciclosporin?
Ciclosporin is a medication that is classed as a DMARD- a disease modifying anti-rheumatic drug. This means it acts on the disease itself to reduce the effects of the immune system.
The immune system causes inflammation that protects the body from infections and injury. In certain diseases however, the immune system is over active and this can target healthy tissues such as joints and blood vessels. This results in pain, swelling and tenderness and eventually permanent damage.
Ciclosporin works to suppress the over activity of the immune system and prevent the inflammation from occurring, reducing the long-term risk of permanent damage.
What is Ciclosporin used for?
Ciclosporin is used for a number of conditions in rheumatology, such as rheumatoid arthritis and systemic lupus erythematosus.
It is also used in different specialities after organ transplant.
How is it taken?
Ciclosporin is taken as a capsule daily. It needs to be swallowed whole. Due to interactions, it is not advised to take it at the same time as citrus fruits such as grapefruit.
It is usually started at a dose based on your weight. It can be increased every 2-4 weeks dependent on your symptoms and blood tests.
It can take up to 12 weeks to have an effect, so it is important you continue to take it even though it may not seem to have any effect straight away.
It is a long-term treatment.
You will receive the first 8 weeks of tablets from the hospital. As the medication can affect the blood counts, liver and kidneys, your blood tests will be checked before you start the tablets and then at intervals during taking it. Initially you will need bloods taken at 2 weeks, 4 weeks and 6 weeks, then once a month for 3 months and then every 3 months whilst you remain on the medication.
Ciclosporin can also cause raised blood pressure, this will be checked at the same time as your bloods.
Following the initial 8 weeks of monitoring by the rheumatology nurse specialists, they will contact you via the phone to ensure you are managing well and hand over the prescription and monitoring to your GP.
There are a small number of side effects that some people can experience when taking ciclosporin, these include:
- Feeling sick
- Headaches and tiredness
- Overgrowth of the gums
- Excess hair growth
- High blood pressure
- Skin rashes
As the immune system is targeted by ciclosporin, it is important to get your blood tests checked. Should you develop signs of infection, stop taking your ciclosporin and speak to your GP as you may require antibiotics. Once you are feeling better and have completed any antibiotics you can restart taking your tablets.
Ciclosporin can also affect the blood cell counts, liver and kidneys. If you notice any yellow discoloration to your skin or eyes, bruising and bleeding you should let your doctor know.
If you develop, or come into contact with anyone with shingles or chickenpox, you should speak to your doctor as you may need treatment and to stop taking your ciclosporin temporarily.
Cautions of use
Interactions with other medications
- Ciclosporin can interact with other medications that affect the immune system; this will be checked before you start taking it.
Contraindications with other conditions
- As ciclosporin can affect the liver and kidneys, your doctor will decide if it is safe to give if you have underlying disease.
- Ciclosporin can make you more likely to develop gout, so it is usually avoided in those who suffer from it.
- It is usually avoided in patients who have previously had cancer.
- Ciclosporin use should be discussed with your doctor and surgeon.
During pregnancy and breastfeeding
- Ciclosporin has been shown to be safe in pregnancy and breast feeding.
- There is no contraindications for males trying to conceive.
- As both ciclosporin and alcohol can affect the liver, it is advised that you do not consume over the recommended 14 units of alcohol weekly.
- It is safe to receive the flu and pneumonia vaccine whilst taking ciclosporin
- The shingles vaccine and other live vaccines are not recommended when taking ciclosporin.
Versus Arthritis: http://www.versusarthritis.org