Ciclosporin-Disease Modifying Anti-Rheumatic Drug

Abriha Varsh^*
*Correspondence: Dr. Abriha Varsh, Department of Veterinary Science, Addis Ababa University, Bishoftu, Ethiopia, Tel: 9345627216, Email:

About the Study

Disease-modifying Anti-rheumatic Drugs (DMARDs) act by altering the underlying disease rather than treating symptoms. They're not painkillers, but they'll reduce pain, swelling and stiffness over a period of weeks or months by slowing down the disease and its effects on the joints. There are two types: conventional DMARDs and biological therapies. Ciclosporin is a type of drug known as a disease-modifying anti-rheumatic drug. In some conditions, the immune system becomes overactive and instead of fighting infection as it’s supposed to, it attacks the body’s own healthy tissues. It can reduce activity in the immune system and help prevent damage to joints.

Uses

Ciclosporin can reduce pain, swelling and stiffness in rheumatoid arthritis. It’s also used to treat a number of other autoimmune and inflammatory conditions, including psoriatic arthritis and lupus. It is a long-term treatment and it may be up to four months before you notice the benefits. It’s important to keep taking it, unless you have severe side effects: even if it doesn’t seem to be working at first; even when your symptoms start to improve, to help keep your condition under control.

Ciclosporin may not be suitable if: you have kidney problems; you have high blood pressure that isn’t controlled by medication; you have gout or high levels of urate in your blood; you’ve had cancer. It is usually prescribed under its brand names: Neoral, Deximune and Capimune. It is taken as capsules to swallow. The capsules will need to be swallowed with water, and you should not chew or open them. It is also available as a liquid to drink. For this method of taking ciclosporin, you’ll need to measure out the correct dose using the syringe that comes with your medicine. Mix it with water and stir it well. After you’ve taken it, add some more water, swish the water around and drink that, to make sure you’ve taken all the medicine. Don’t drink grapefruit juice or pomelo juice to take your ciclosporin with. These can increase the amount of ciclosporin in your body and so increase the risk of side effects. It’s best to completely avoid drinking these fruit juices or eating these fruits when taking ciclosporin. It might be a good idea to take the medicine at the same time each day, so that you get into a routine of taking it.

Side effects

Possible side-effects of ciclosporin include a rise in blood pressure and effects on your kidneys. It can sometimes cause increased levels of lipids (cholesterol) in the blood. You'll have regular blood tests and your blood pressure will also need to be checked frequently while you're on ciclosporin. You may be asked to keep a record of your blood test results in a booklet, and you should take it with you when you visit your GP or the hospital. You must not take ciclosporin unless you're having regular checks. There are different brands of ciclosporin available and, although the drug itself is the same in all the brands, it may be absorbed differently. Your doctor will try to keep you on the same brand if possible. If it's necessary to change to another brand your doctor may advise more frequent checks to make sure the levels of drug in your blood remain the same. To improve side-effects you may be advised to reduce the dose of ciclosporin. You should tell your doctor or rheumatology nurse specialist if you develop any of the following after starting ciclosporin: nausea (feeling sick); diarrhea; headache; gum overgrowth; tiredness; excess hair growth; any other new symptoms or anything else that concerns. You should also check if you develop chickenpox or shingles or come into contact with someone who has chickenpox or shingles. These infections can be severe in people on treatments that affect the immune system such as ciclosporin. You may need antiviral treatment, and your ciclosporin is usually stopped until you're better. Grapefruit and grapefruit juice can increase the effects of ciclosporin, which can also increase the risk of side-effects.