Cancel arthritis with cyclosporine

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Cyclosporine (Sandimmune, Neoral) is an immunomodulating drug that inhibits interleukin-1 synthesis and release. Interleukin-1 is a chemical messenger that increases inflammation.

Information from Sandimmune

This drug has been used to treat severe refractory rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus.

Oral absorption of cyclosporine is erratic and affected by food intake. The drug is highly bound to plasma proteins and is metabolized by the liver. Starting dosage is 2 mg per kilogram in divided dosage. The dose may be increased slowly every 4 weeks to a maximum of 4 to 5 mgs per kilogram per day.

Baseline blood pressure, complete blood cell count, liver and kidney function blood tests, and urinalysis should be obtained. As dosage is increased, monitoring should be done every 2 weeks. Once maintenance dosing has been achieved, monitoring can be done every 4 weeks.

If the blood pressure rises to a diastolic of 90 mm or higher, cyclosporine dosing needs to be adjusted downward. If the blood creatinine rises higher than 30 per cent of baseline, then cyclosporine dosing needs to be adjusted downward as well.

Side effects include hypertension, worsening of kidney function, nausea, muscle cramps, seizures, headaches, muscle inflammation, pancreatitis, excessive gum growth, elevations in blood potassium and uric acid, and drops in blood magnesium.

Patients need to avoid excessive sunlight exposure.

Cyclosporine also interacts with a number of medicines including antibiotics, anti-fungal drugs, some calcium channel blocking heart drugs and grapefruit juice… all of which increase cyclosporine blood levels.

Anti seizure medicines and anti tuberculosis drugs decrease cyclosporine concentrations.

Diuretics that cause a patient to hold onto potassium may lead to elevated blood potassium levels.

Cholesterol lowering drugs can lead to increased chance for muscle damage.

Drugs that affect kidney function may have a worsening effect when taken along with cyclosporine. An example would be the patient who requires non-steroidal anti-inflammatory drug therapy.

Cyclosporine has been used mostly in combination with methotrexate for patients who have severe rheumatoid arthritis. This drug is being used much less now that biologics are available.

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