Ciclosporin

Commercial name

Sandimmun®, Ciqorin®

Before therapy

Blood count, liver values, kidney values, blood pressure, electrolytes (Mg, K), U-status, lipids, hepatitis B/C, HIV serology

Administration

p.o.

Dosage

2-3 mg /kg bw /d initial, with inefficiency increase by 0.5-1 mg /kg bw /d, maximum 5 mg/kg bw/d

Median effect of action

4 weeks

Be careful

Nephrotoxic drugs, liver diseases, other immunosuppressants, previous phtotherapy, live vaccines. Annual flu and pneumococcal vaccination recommended, individual risk assessment for HIV infection. Combination with statins: Danger of myopathies CAVE: Effect of pro- gesteron-containing anti-contraceptives can be reduced.

Contraindications

Renal dysfunction, uncontrolled arterial hypertension, severe infections, malignancies, except excised epithelial skin tumors, lactation, chronic hypertension, chronic skin cancer. Hep B (pos HbsAG). Simultaneous PUVA therapy

Anamnesis points, selected side effects and measures

Creatinine increase by ≥30 % -> liquid, possibly dose reduction. Arterial hypertension >160/90mmHg -> antihypertensive therapy (calcium antagonists). Gingiva hyperplasia -> dental hygiene, possibly stop. tremor, rising lipid levels

Duration of theraphy

Side effects at 3-5 mg/kg are usually limited to a few weeks to months. For inflammatory skin diseases no longer than 12 months due to calcineurin inhibitor-induced nephropathy and increased carcinogenesis.

Format

Eye drops

Application

topical