Cyclosporine

Cyclosporine – the synthetic immunodepressive drug used for prevention of reaction of rejection after operations on organ transplantation or marrow.

Pharmacological effect of Cyclosporine

Active component of Cyclosporine has an immunodepressive effect, selectively influencing T lymphocytes.

As a result of use of Cyclosporine reactions of humoral and cellular immunity and activation of lymphocytes are slowed down, at the same time medicine does not exert impact on functioning of the englobing cells.

Release form

Cyclosporine is produced in a look:

• The powder containing active component in number of 25 mg;
• The soft capsules containing active component in number of 25, 50 and 100 mg;
• Solutio oleosa for the intake containing active component in number of 100 mg in bottles on 50 ml.

Cyclosporine analogs

Cyclosporine analogs on active ingredient are the following drugs: Orgasporin, Sandimmun, Tsiklopren, Panimun Bioral, Ekoral.

On a way of action drugs Advagraf, the Pro-count, Takrolimus-Richter, Takrolimus-Teva and Takrosel belong to analogs of Cyclosporine.

Indications to Cyclosporine use

According to the instruction Cyclosporine is appointed along with other immunosuppressive drugs and glucocorticoids for prevention of reaction of rejection after operations on change:

• Kidneys;
• Marrow;
• Hearts;
• Liver;
• Pancreas;
• Lungs.

Also Tsiklosporin is effective at treatment and prevention of a disease "a transplant against the owner" in cases if earlier treatment was carried out by other immunodepressants.

Besides, Cyclosporine according to the instruction is appointed at treatment:

• Autoimmune diseases;
• The endogenous active uveitis menacing to sight of the average or back site of the eye caused by a noninfectious etiology in cases when standard therapy results in undesirable side effects or does not yield result;
• Bekhchet's uveitis, especially at recurrent attacks of an inflammation which affects a retina;
• Severe forms of atopic dermatitis;
• Steroid-dependent and steroid - a resistant form of a nephrotic syndrome in a remission stage;
• Heavy persistent course of psoriasis;
• Severe forms of a pseudorheumatism at impossibility of use of slowly operating antirheumatic medicines or their inefficiency.

Contraindications

It is contraindicated to apply cyclosporine according to the instruction:

• Against the background of malignant new growths;
• In pediatrics (up to one year);
• At precancerous diseases of skin;
• At hypersensitivity to active or to auxiliary components of Cyclosporine, including the polyhydroxyethylated castor oil in the dosage forms supporting him;
• In the period of a lactation.

Cyclosporine should be applied with care at:

• To the flowing or recently postponed chicken pox;
• Renal and liver failure;
• Varicella zoster or other viral diseases (because of risk of generalization of process);
• Arterial hypertension;
• Hyperpotassemias;
• Sprue.

Cyclosporine route of administration

As a rule, the scheme of treatment by Cyclosporine depends on indications and is established by the doctor individually taking into account laboratory and clinical parameters.

In the Cyclosporine capsule according to the instruction appoint not later than 12 hours before operation on organ transplantation in a dosage at the rate of 10-15 mg to 1 kg of the weight divided into 2 receptions.

After operation daily for several weeks Cyclosporine is accepted in the same dosage then slowly the amount of the accepted drug is reduced to the supporting daily dose (2-6 mg on 1 kg).

The reduced dosages can be used if medicine is applied together with other immunodepressants and glucocorticoids.

When carrying out operations on bone marrow transplantation Cyclosporine is applied according to the same scheme, however in this case the supporting dosage makes 12,5 mg/kg a day, and in cases of disturbance of absorption apply higher doses.

The supporting treatment by Cyclosporine should be continued for half a year then the accepted medicine doses gradually reduce. As a rule, the general duration of reception of Cyclosporine makes one year, and in rejection reaction development cases treatment can longer continue.

At treatment of endogenous uveites and a nephrotic syndrome the initial daily dosage makes 5 mg on 1 kg. Cyclosporine is accepted before improvement of visual acuity and a zatikhaniye of an inflammation. In cases when monotherapy does not bring the expected result, perhaps simultaneous use of Cyclosporine with small doses of glucocorticoids.

At treatment of a pseudorheumatism for the first 6 weeks of therapy by Cyclosporine the daily dose makes 3 mg on 1 kg of weight divided into 2 receptions. The general duration of administration of drug should not exceed twelve weeks.

At treatment of psoriasis and atopic dermatitis the daily dose varies from 2,5 to 5 mg/kg divided into 2 receptions. After improvement the Cyclosporine dose is gradually reduced to full cancellation.

Medicinal interaction of Cyclosporine

At combined use of Cyclosporine with:

• Non-steroidal anti-inflammatory drugs – the risk of emergence of side effects from kidneys increases;
• Amphotericinum In, antibiotics of group of aminoglycosides, colchicine, Trimethoprimum, ciprofloxacin, Melphalanum – the risk of development of nephrotoxicity increases;
• Potassium drugs – the risk of development of a hyperpotassemia increases;
• Lovastatin – the risk of development of weakness and muscular pains increases.

Side effects of Cyclosporine

Cyclosporine according to reviews at use after transplantation can cause the limfoproliferativny diseases which are shown as a lymphoma and malignant diseases of skin.

In some cases, with hypersensitivity to the polyhydroxyethylated castor oil, Cyclosporine according to reviews can cause anaphylactic reactions in a look:

• Acute respiratory distress syndrome;
• Skin rash;
• Shock;
• "Inflows" of blood to face skin and an upper part of a trunk;
• Bronchospasm;
• Tachycardias;
• Lowerings of arterial pressure.

At Cyclosporine use according to reviews treat other disturbances of systems of an organism:

• Nephropathy;
• Increase in body weight;
• Hyperplasia of gums;
• Tremor;
• Hyperpotassemia;
• Headache;
• Hypomagnesiemia;
• Paresthesias;
• Pancreatitis, abdominal pain;
• Arrhythmias;
• Lipidemia;
• Allergic reactions;
• Nausea, loss of appetite, vomiting or diarrhea;
• Increased feeling of fatigue and weakness;
• Hepatotoxic;
• Thrombocytopenia;
• Hypostases;
• Myasthenia, muscular spasms and myopathy;
• Burning in hands and ступнях legs;
• Vision disorder, consciousnesses or movements;
• Encephalopathy;
• Anemia;
• Dysmenorrhea, amenorrhea.

Storage conditions

Cyclosporine belongs to a number of immunodepressive means of a prescription issue with a period of storage up to three years at observance of the recommended requirements to storage.