CYCLOSPORINE
Main uses in hair loss: Rarely used in scarring alopecia (lichen planopilaris, discoid lupus), alopecia areata
Other names: Neoral, Sandimmune
What is cyclosporine?
- Cyclosporine is an immunosuppressant medication. It is sometimes used to treat scarring hair loss conditions that haven’t responded to other medications. Less commonly, it is used to treat alopecia areata.
Who should not take cyclosporine?
Be sure to check with your own doctor if cyclosporine is right for you. Patients with any of the following conditions may or may not be advised to take cyclosporine
- patients with kidney problems
- patients with blood pressure problems
- patients who are allergic to the drug
- patients with a history of cancers
- patients on medications that interfere with cyclosporine
- patients with infections
What is the typical dose?
- Check with your doctor for what dose to use. Usually the drug is given according to a patient’s weight
What side effects are possible with cyclosporine?
The following is a partial list of some of the possible side effects. A complete list is available from the pharmacist and your prescribing physician. In general, many patients are able to take cyclosporine without side effects. However, it’s not possible to predict who will develop these side effects and who will not.
Side effects include:
- kidney problems
- high blood pressure
- neurological problems such as tremor, headaches, pins and needles
- thickening of the gums (called gingival hyperplasia)
- increased hair growth on the face or body
- gastrointestinal problems such as nausea, vomiting and discomfort
- muscle and joint pains
- high potassium levels in the blood, low magnesium, high fats and cholesterol
- development of gout
Are tests needed before starting cyclosporine?
- Yes, baseline blood tests, blood pressure checks and skin exam are usually done before starting this drug.
Are tests needed after starting cyclosporine?
- Yes, you will be asked to get blood tests frequently after starting cyclorsporine and asked to return for blood pressure monitoring frequently.
Do some drugs interfere with cyclosporine?
- There is a very, very large list of medications that interact with cyclosporine so be sure to tell your doctor all the medications you take. This includes simple things like St John’s wart used for depression as well as other medications. Cyclosporine can not be used with grapefruit juice
- The following medications interact with cyclosporine. Be sure to tell you doctors as well as pharmacist if you take these medications and are considering cyclosporine. The following medications may or may not be allowed.
- anti depressants like SSRI type antidepressants
- anti-viral drugs (protease inhibitors)
- anti-fungal medications
- anti-histamines
- allopurinol
- beta blockers
- calcium channel blockers
- diuretics
- birth control pills
- grapefruit juice
- rifampin
- isoniazid
- anticonvulsants
- griseofulvin
- aminoglycoside antibiotics
- NSAIDS (ibuprofen and other meds)
- Septra antibiotics
- Hydroxychloroquine (Plaquenil)
- Sulfa drugs
- ACE inhibitor blood pressure medications
- Potassium pills
- Potassium sparing diuretics
- Digoxin
- Lovastatin