Cyclosporine - a synthetic immunosuppressant drug used to prevent rejection after organ transplants or bone marrow.
The pharmacological action of Cyclosporine
Active ingredient Cyclosporin has immunosuppressive action acting selectively on T-lymphocytes.
As a result of slowing the reaction Cyclosporin humoral and cellular immunity and activation of lymphocytes, wherein medicine has no influence on the functioning of phagocytic cells.
Cyclosporine produced in the form:
- A powder containing the active ingredient in an amount of 25 mg;
- Soft capsules containing the active ingredient in an amount of 25, 50 and 100 mg;
- Oily solution for oral administration comprising the active ingredient in an amount of 100 mg, in vials of 50 ml.
Cyclosporin analog of the active substance are the following drugs: Orgasporin, Sandimmun, Tsiklopren, Panimun Bioran, Ekoral.
By way of action to include drugs cyclosporin analog Advagraf, Prograf, Tacrolimus-Richter, tacrolimus, and Teva Takrosel.
According to the instructions Cyclosporin administered in conjunction with other immunosuppressive drugs and corticosteroids for the prevention of rejection after transplants:
- Bone marrow;
Cyclosporine is also effective in the treatment and prevention of disease, "graft versus host" in cases where the treatment was carried out before other immunosuppressants.
In addition, cyclosporin is prescribed for the treatment of instructions:
- Autoimmune diseases;
- Endogenous active uveitis, sight-threatening intermediate or rear portion of the eye caused by non-infectious etiology, in cases where standard therapy leads to unwanted side effects, or does not work;
- Uveitis, Behcet's disease, especially in recurrent attacks of inflammation that affects the retina;
- Severe forms of atopic dermatitis;
- The steroid-dependent and steroid-resistant forms of nephrotic syndrome in remission;
- Heavy persistent flow of psoriasis;
- Severe forms of rheumatoid arthritis in the inability to use the slow-acting anti-rheumatic drugs or their ineffectiveness.
Cyclosporine is contraindicated for instructions apply:
- Against the background of malignant tumors;
- In Pediatrics (up to one year);
- When precancerous skin diseases;
- When hypersensitivity to active or auxiliary components Ciclosporin, including polyoxyethylated castor oil in dosage forms containing it;
- During the period of lactation.
Cyclosporine should be used with caution in:
- Current or recent chicken pox;
- Kidney and liver failure;
- Varicella zoster or other viral infections (due to the risk of generalization);
- Malabsorption syndrome.
Generally, cyclosporin regimen depends on the indication and set individually in accordance with a physician and clinical laboratory parameters.
Inside the capsule Cyclosporine is prescribed according to the instructions no later than 12 hours before organ transplants at a dosage rate of 10-15 mg per 1 kg of body weight, divided into 2 doses.
After the operation, everyday for a few weeks Cyclosporin taken at the same dosage, then slowly reduce the amount of drug received to support the daily dose (2-6 mg per 1 kg).
Reduced dosages may be used if the drug is used in conjunction with other immunosuppressive agents and corticosteroids.
In carrying out transplantations of bone marrow Cyclosporin used in the same way, but in this case 12 supports the dosage is 5 mg / kg per day, and in cases of malabsorption apply higher doses.
Maintenance treatment of cyclosporine should continue for six months, after which the dose of the drug taken gradually reduced. Typically, the total length of receiving Cyclosporine is one year, and in the cases of rejection treatment may last longer.
In the treatment of endogenous uveitis and nephrotic syndrome initial daily dosage of 5 mg per 1 kg. Cyclosporine take to improve visual acuity and remission of inflammation. When monotherapy does not bring the expected result, it is possible the simultaneous use of Cyclosporine with small doses of glucocorticoids.
In the treatment of rheumatoid arthritis during the first 6 weeks of therapy cyclosporine daily dose is 3 mg per 1 kg weight, divided into 2 doses. The total duration of the drug should not exceed twelve weeks.
In the treatment of psoriasis and atopic dermatitis daily dose varies from 2, 5 to 5 mg / kg, divided into 2 doses. After improving Cyclosporine dose gradually reduced to a total abolition.
Drug Interactions Cyclosporine
When combined with Cyclosporine:
- Nonsteroidal anti-inflammatory drugs - increases the risk of side effects from the kidney;
- Amphotericin B, aminoglycoside antibiotic, colchicine, trimethoprim, ciprofloxacin, melphalan - increases the risk of nephrotoxicity;
- Potassium supplements - increases the risk of hyperkalemia;
- Lovastatin - increases the risk of muscle weakness and pain.
Side effects Cyclosporine
Cyclosporine Review the application of post-transplant lymphoproliferative disease can cause, manifested as lymphoma and malignant skin diseases.
In some cases, the presence of hypersensitivity to polyoxyethylated castor oil Cyclosporin Review can cause anaphylactic reactions in the form:
- Acute respiratory distress syndrome;
- Skin rash;
- "Tides" of blood to the face and upper body;
- Lowering blood pressure.
Other violations of body systems in the application of Cyclosporine for reviews include:
- Weight gain;
- Gingival hyperplasia;
- Pancreatitis, stomach pain;
- Allergic reactions;
- Nausea, loss of appetite, vomiting, or diarrhea;
- The increased feeling of tiredness and weakness;
- Myasthenia gravis, muscle spasms and myopathy;
- Burning sensation in the hands and soles of the feet;
- Blurred vision, or movement of consciousness;
- Dysmenorrhea, amenorrhea.
Cyclosporine belongs to a number of immunosuppressive agents prescription with a shelf life of up to three years under recommended storage requirements.