Cyclosporine

Cyclosporine is an immunosuppressant sometimes prescribed for autoimmune disorders in dogs who are unresponsive to other treatments. Cyclosporine inhibits the action of the cells and proteins that signal to other cells to initialize an immune response.

This medication is commonly given to suppress immune responses in transplant patients to reduce the chances of organ rejection. Cyclosporine is also effective at treating canines with hemolytic anemia, a potentially life-threatening disorder where the immune system destroys healthy red blood cells. 

Other conditions for which vets prescribe this medicine include anal fistulas, severe allergies, systemic scleroderma, IBS, and rheumatoid arthritis, to name a few. Cyclosporine is typically a last-resort treatment since it comes with serious side effects and is hazardous to healthy individuals. 

Dosage

Vets typically start canines on a higher dosage and gradually wean them down to the smallest effective dose. An average starting dose of this medication is around 1.5 mg to 3 mg per pound every 12 hours. 

Dosage instructions

Cyclosporine works best on an empty stomach. Hold off on feeding your dog for at least 2 hours before or after giving this medicine. Always use gloves when in contact with this medication since it can cause serious health problems in people if handled improperly.

Efficacy

One placebo-controlled study on the efficacy of cyclosporine in dogs as a treatment for atopic dermatitis found that high doses of this medication significantly reduced dermatological symptoms in most of the dogs. 

A different treatment study of dogs with anal fistulas found that cyclosporine had a 100% success rate and promoted healing in dogs who were unresponsive to traditional antibiotics. 

A study of 14 dogs with steroid-induced irritable bowel syndrome found that cyclosporine decreased symptoms of IBS in all but 2 dogs. 

Side effects

Cyclosporine causes a wide range of side effects, but the most common are lack of appetite and upset stomach. Other adverse effects this medication can cause include:

• Opportunistic infections

• UTI

• Loss of appetite

• Watery stools

• Outer ear infection

• Lymph node swelling 

• Extreme fatigue

• Change in gums

• Mucous secretions 

• Hyperkeratinization of the paws

• Changes in fur appearance

• Dry cough

• Nephropathy

• Unusual thirst

Considerations

The FDA requires several black box warnings for cyclosporine-containing drugs. One of these warnings states cyclosporine increases susceptibility to sometimes deadly secondary infections. Another of these warnings states cyclosporine treatment requires regular blood analyses to ensure the proper dosage and avoid liver toxicity. 

This medication poses a significant risk of skin cancer for dogs with psoriasis who are taking concurrent cancer treatments, immunosuppressants, and UV light therapy. 

Research shows this medication causes fetal harm, birth defects, and neonatal death in the offspring of lab animals. Cyclosporine passes into the mother's milk so it shouldn't be given to lactating dogs. 

Canines with a history of cancer, hypertension, and low kidney functionality should avoid this medication, since cyclosporine may worsen these conditions. 

Drug interactions

Cyclosporine conflicts with a lot of different medications, including:

• Certain antibiotics

• -azole antifungals

• Prednisolone

• Heartburn medications

• Piroxicam

• Lodine (Etodolac)

• Methylprednisolone

• Zyloprim, Aloprim

• Supplements containing St, John's Wart

Allergic reactions and sensitivity

Despite its use as a treatment for severe allergies, cyclosporine can trigger allergic reactions in some dogs. Inform your vet if your dog has had reactions to oral or ophthalmic drugs containing cyclosporine. 

Signs your dog may be having an adverse reaction to this medication include white gums, frequent watery stools, vomiting, itching, respiratory problems, and puffy face. 

Frequently asked questions

What forms does cyclosporine come in for dogs?

Cyclosporine is available as an ophthalmic solution, gel capsule, liquid suspension, oral tablet, and an intravenous solution. 

Is cyclosporine safe for pregnant and nursing dogs?

No. Research shows this medication is harmful to both unborn and nursing offspring of mammals. 

Is cyclosporine safe for dogs of low body weight?

Most vets approve this medication for dogs above 4 lbs and those older than 6 months. There isn't any research on the safety of cyclosporine in dogs younger than 6 months or smaller than 4 lbs. 

What's the brand name of cyclosporine for dogs?

Cyclosporine goes by several different brand names, including Atopica, Restasis, Neoral, Sandimmune, and Gengraf. 

Will cyclosporine cure my dog's autoimmune disease?

This medication isn't a cure for autoimmune conditions, though it can prevent immune responses and symptomatic flare-ups when given long-term. 

How long does it take cyclosporine to work?

You may notice your pet responds to this medication in as little as 2 weeks or as long as 4 months. 

Does my dog need to avoid any foods while taking cyclosporine?

The only food that interferes with the action of cyclosporine is grapefruit, though most dogs won’t eat it.