Atopica

Immune-mediated skin diseases in dogs and cats including atopic dermatitis, perianal fistulas, and sebaceous adenitis; oral cyclosporine. Calcineurin inhibitor (cyclosporine). Mechanism: binds cyclophilin → cyclosporine-cyclophilin complex inhibits calcineurin phosphatase → prevents nuclear translocation of NFAT → blocks transcription of IL-2 and other T-cell cytokines → T-lymphocyte immunosuppression. Also inhibits mast cell activation. Hepatically metabolized via CYP3A4; lipophilic. Key information Refrigerate oral solution. Administer on empty stomach (1 hour before or 2 hours after feeding) for consistent absorption. Immunosuppressant — increased infection risk. Grapefruit juice interaction (avoid). Monitor for GI effects (give with small amount of food if GI upset occurs). Annual lymph node exam recommended.

Oral capsules (dogs): administer on an empty stomach (1 hr before or 2 hrs after feeding) for best absorption. If GI upset occurs, may give with a small amount of food temporarily. Swallow whole — do not open capsule. Store at room temperature; protect from light. Ophthalmic ointment (Optimmune): see ophthalmic entry. If a dose is missed Administer as soon as you remember. If it is almost time for the next scheduled dose, skip the missed dose and resume the normal schedule. Never double up doses to make up for a missed one. Administer consistently. Do not double doses.

GI: vomiting, diarrhea, anorexia (most common; may improve with food administration or temporary dose reduction). Gingival hyperplasia. Papillomatosis (viral warts). Increased susceptibility to infections (fungal, viral, bacterial). Lymphoma risk with prolonged immunosuppression. Nephrotoxicity (monitor renal function). Hypertrichosis.

For animals Do not use in patients with active infections or malignancy. Pre-treatment: rule out demodicosis, dermatophytosis, Malassezia. Avoid live vaccines during therapy. Monitor renal function, hydration status, and urine output. Monitor liver enzymes with prolonged use. Monitor for papillomatosis and new skin infections. Feline: begin at every-other-day dosing; higher GI sensitivity. Avoid in pregnant animals. For people handling this medication Wear gloves when handling. Wash hands thoroughly with soap and water after handling. Avoid contact with eyes; if contact occurs, flush with water for 15 minutes and seek medical attention. Cyclosporine is an immunosuppressant. Avoid skin contact — wear gloves when handling capsules. Keep out of reach of children. Pregnant women and women of childbearing age should avoid contact. Immunocompromised individuals should take extra precautions. Keep out of reach of children.

Contact your veterinarian. Cyclosporine overdose causes vomiting, diarrhea, kidney damage, and immunosuppression.