Cyclosporine for rheumatoid arthritis

Examples

Generic Name	Brand Name
cyclosporine	Neoral, Sandimmune

Cyclosporine is given orally (by mouth).

How It Works

Cyclosporine is an immunosuppressive medication, which means that it decreases the action of your body's immune system. By interrupting the immune process, cyclosporine reduces inflammation and slows damage to your joints. Cyclosporine is a disease-modifying antirheumatic drug (DMARD), which means that it slows the progression of rheumatoid arthritis. DMARDs are also called slow-acting antirheumatic drugs (SAARDs).

Why It Is Used

Cyclosporine is sometimes used for severe rheumatoid arthritis that has not responded to most other DMARD treatment.

How Well It Works

Cyclosporine can be effective for severe rheumatoid arthritis. Studies have shown that treatment with cyclosporine for at least 4 months significantly reduces joint inflammation, pain, and disease activity while improving joint function.¹ However, its use is limited because of its toxicity and because it may interact with other medications you are taking.²

Side Effects

Because cyclosporine decreases the activity of your body's natural immune system, fever and chills are considered serious side effects that should be reported to your health professional immediately.

Side effects of cyclosporine include:

• Reduced kidney function.
• Increased blood sugar levels (diabetes).
• Increased cholesterol levels.
• Sleep problems.
• Headache, tremor, or tingling of the fingers and feet.
• High blood pressure.
• Increased hair growth.

Rare side effects include:

• Depression.
• Allergic reaction.
• Kidney failure.
• Liver inflammation.
• Low blood counts.
• Seizures.

While you are taking cyclosporine, your blood pressure and kidney function should be checked regularly.

Talk to your doctor or pharmacist about drinking grapefruit juice while you are taking cyclosporine. Grapefruit juice can increase the level of this medicine in your blood. Having too much medicine in your blood increases your chances of having serious side effects.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

In general, cyclosporine is more toxic than other DMARDs, such as methotrexate, and should be used only under the supervision of a specialist in rheumatoid disease (rheumatologist) who is completely familiar with its side effects.

Cyclosporine is most often used to prevent the body from rejecting a newly transplanted organ.

Talk to your health professional before taking cyclosporine if you are breast-feeding, pregnant, or thinking about becoming pregnant.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Robin Parks, MS	Last Updated August 23, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Stanford M. Shoor, MD - Rheumatology
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