Inflammatory Bowel Disease (IBD) is an autoimmune condition, meaning a condition in which the body’s immune system attacks healthy cells in the body. Immunosuppressants are used with autoimmune conditions, such as IBD. They suppress the body’s immune system and prevent or reduce the immune system from attacking healthy cells in the body.
Cyclosporine is an immunosuppressant that is normally reserved for use with Ulcerative Colitis patients who have not responded well to other medications.
Cyclosporine belongs to a class, called Calcineurin Inhibitors. This class of medications binds to and inhibits calcineurin. Calcineurin is a cellular enzyme that is responsible for the proliferation of a type of white blood cells, called T-lymphocyte, which plays a critical role in immunity.
Besides ulcerative colitis, Cyclosporine is used to prevent the body from rejecting the transplanted organ, and treat severe rheumatoid arthritis, severe plaque psoriasis, and certain eye conditions.
Cyclosporine can be taken in the form of:
- Orally as capsules or solution
- Intravenously with Injections given (an infusion into a vein over a period of time)
- Eye drops
In the oral form, is important to take the products, in the same manner, each time – always with food or always on an empty stomach. Also, take Cyclosporine at the same time of day. Speak with your doctor about this and follow all instructions.
Drug and food interactions of Cyclosporine
Some of the medications that have major interactions and should not be taken with Cyclosporine are:
- Simvastatin
- Pitavastatin
- Cochicine
- Bosentan
- Lercanidipine
- Dronedarone
This is not the complete list. Talk to your doctor before taking any other medications with Cyclosporine.
Additional warnings include:
- Do not start, stop or change the dose of any drug without checking with your doctor. This includes over the counter medications, and herbal or vitamin supplements.
- Do not use supplements or salt substitutes containing potassium without first checking with your doctor.
- Avoid grapefruit or grapefruit juice with Cyclosporine as these will increase the amount of medicine in the body.
Adverse effects of Cyclosporine
Kidneys
Cyclosporine can cause serious kidney problems, including infection with a virus, called the BK virus. BK virus infection may cause kidney loss in kidney transplant patients.
Check with your doctor immediately if you experience any of the following symptoms:
- Change in the amount of urine passed
- Difficulty or pain when passing urine
- Blood in the urine
- Nausea or vomiting
- Swelling of the feet or lower legs
- Weakness
High blood pressure
High blood pressure can occur with this medication, generally within the first few weeks of therapy. Talk to your doctor about checking your blood pressure regularly.
Brain and nerves
Cyclosporine and other calcineurin inhibitors can cause pain syndrome. There can be symmetrical pain in the lower limbs, usually involving the bones of the feet, ankles, and knees.
A brain condition, called Posterior Reversible Encephalopathy Syndrome (PRES), which may be very serious and sometimes deadly, has occurred with this drug. Check with your doctor immediately if you develop symptoms, such as seizures, confusion, reduced alertness, change or loss of eyesight, or intense headache. A mild tremor is also common with Cyclosporine.
Liver
Even though it is rare, Cyclosporine may cause serious liver problems. Check with your doctor immediately if you experience:
- Nausea
- Vomiting
- Loss of appetite
- Pain or tenderness in the upper stomach
- Pale stools
- Dark urine
- Yellow eyes or skin
Predisposition to cancer
There may be an increased risk of skin cancer with Cyclosporine. Talk to your doctor about scheduling regular skin examinations. Avoid sun, sunlamps and tanning beds. Always use sunscreen and wear clothing and eyewear to protect you from the sun.
Lymphoma, cancer of infection-fighting cells, may occur with this medication. Talk to your doctor if you have concerns about this risk.
Increased risk of infections
Because Cyclosporine is an immunosuppressant, there is an increased risk for infection. Check with your doctor immediately if you experience:
- Any signs of infection, such as sore throat, fever, chills, flu-like symptoms. cough, more phlegm or change in color of phlegm
- Ear or sinus pain
- Painful urination
- Mouth sores
- A wound that will not heal
Avoid being near people who are sick, and wash your hands often.
Metabolic abnormalities
A high potassium level and low magnesium level may occur with Cyclosporine. Check with your doctor if you experience mood changes, seizures, confusion, muscle pain or weakness, a heartbeat that does not feel normal, not hungry, or very bad upset stomach or throwing up as these may be signs of electrolyte problems.
Cyclosporine may cause high blood sugar levels. If you have diabetes, you will need to watch your blood sugar closely.
Cyclosporine may increase total cholesterol and low-density lipoprotein (LDL) cholesterol (the bad cholesterol). Talk to your doctor regarding this.
Cyclosporine can cause high uric acid levels in the blood. Watch out for attacks of gout.
Things to know or do while taking Cyclosporine
Do not have any immunizations or vaccines without your doctor’s approval while being treated with Cyclosporine or after you stop treatment with Cyclosporine. Because Cyclosporine lowers the body’s resistance to infections, you might get an infection using the vaccine that is meant to prevent it.
You should not be around people who have received live virus vaccines, as it is possible they could pass the virus on to you. Examples of live vaccines include influenza (nasal flu vaccine), poliovirus (oral form), rotavirus, measles, mumps, and rubella.
Some people may experience tenderness, swelling, or bleeding of the gums. Massaging your gums, brushing and flossing your teeth regularly may help prevent this. Check with your doctor or dentist if you experience swelling, tenderness, or bleeding of the gums.
Other side effects associated with the use of Cyclosporine are loss of appetite, abdominal discomfort, nausea, vomiting, and diarrhea.
Cyclosporine is very strong medicine and may cause serious side effects, including kidney problems. This medicine is occasionally used in the treatment of various immune-mediated diseases. Your doctor will weigh the benefits against the risks when taking this medication.
Learn about the various medications used in the treatment of inflammatory bowel disease. You’ll want to understand the risks and benefits and decide with your doctor if the medication your doctor recommends is right for you.
