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Ciclosporin : Neoral, Sandimmune, Restasis

  • Ciclosporin or cyclosporine or also cyclosporin is a calcineurin inhibitor, used as an immunosuppressive drug. 
  • It is a natural medicine used through capsules to be drunk orally or by intravenous injection to treat many skin diseases, such as psoriasis, bullous pemphigoid, and skin allergies. 
  • It is also used in the form of eye drops for some diseases of the eyes such as pemphigoid cicatricial.

What is the other trade name for ciclosporin? 

  • Brand names of cyclosporine are multiple, such as Neoral, Sandimmune, Restasis, and many others.

How does ciclosporin work?

  • Ciclosporin works by decreasing lymphocyte function. This is done by blocking the phosphatase activity of calcineurin, which decreases the production of inflammatory cytokines by T cells.

History of ciclosporin

  • Cyclosporine was discovered in 1971 and from a fungus whose name is "Tolypocladium inflatum" and entered medical practice only in 1983.
  • The World Health Organization (WHO) classifies it in the list of essential medicines.

Medical uses of Ciclosporin

  • Ciclosporin is indicated in the treatment of several diseases. Among its indications in dermatology, we find:
    • Severe forms of psoriasis
    • Severe forms of atopic dermatitis
    • Autoimmune bullous dermatoses (especially Epidermolysis bullosa acquisita)
    • Behcet's disease
    • Kimura's disease
    • Pyoderma gangrenosum
    • Chronic urticaria
    • Acute systemic mastocytosis

Ciclosporin contraindication

  • Ciclosporin contraindications are
    • Uncontrolled hypertension
    • Kidney failure
    • active infection
    • cancer (except basal cell carcinoma)
    • Hepatic Insufficiency
    • immune deficiency

Side Effects of Ciclosporin

  • The side effects of ciclosporin are:
    • enlarged gums
    • hypertrichosis
    • pancreatitis
    • confusion and seizures
    • fever
    • peptic ulcers
    • nausea and vomiting
    • diarrhea
    • increased cholesterol
    • dyspnea
    • numbness
    • tingling, especially on the lips
    • Pruritus
    • HTA: The increase in blood pressure can cause cardiovascular events; it is therefore recommended to use the lowest effective dose for people requiring long-term treatment.
    • Retention of potassium and at most hyperkalemia Disturbance of liver and kidney balance sheets
    • Burning sensation in the fingertips
    • Increased vulnerability to opportunistic infections.
    • Increased blood uric acid levels after kidney transplantation
  • Ciclosporin is classified as an IARC Group 1 carcinogen (i.e. there is sufficient evidence of carcinogenicity in humans), leading specifically to squamous cell skin cancer and non-Hodgkin's lymphoma.

Veterinary use of ciclosporin

Ciclosporin is approved to treat atopic dermatitis in dogs. It is also used to treat sebaceous adenitis, pemphigus foliaceus and anal furunculosis


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