Nephrotic Syndrome adverse effect and precautions

Cyclosporine is an immunosuppressant drug widely used in post-allogeneic organ transplants such as kidneys, liver, or heart to reduce the activity of the patient's immune system.

Cyclosporine is a conventionally used medicine for autoimmune diseases such as Psoriasis, Rheumatoid arthritis, Crohn's disease, Nephrotic Syndrome, etc. where the patient does not respond to the treatment with corticosteroids or methotrexate.

Cyclosporine is a very good immune-suppressive medicine but makes the patient susceptible to infection including cancer such as lymphoma.

The adverse effects could be listed as:

1) Adverse effects, which require immediate medical help (alarming signs), are:

• Hypertension: Above 50% of patients taking cyclosporine develops high blood pressure. A known case of hypertension has a risk of developing heart disease.
• Kidney Dysfunction:Scanty urine presenting as decreased frequency of urination or no urine at all.
• The risk of both these problems increases with higher doses and longer treatment with cyclosporine.
• Allergic reactions present as hives, swelling of the face lips, and throat, or difficulty in breathing.
• Seizure (convulsion)
• Tachycardia (fast heart rate), muscle weakness or pain
• Flu-like symptoms such as fever chills and sore throat
• Jaundice presents as yellowing of skin and sclera, dark urine, nausea, and clay-colored stools.
• Drowsiness, confusion, and mood changes
• Easy bruising and bleeding
• Swelling and weight gain
• gum disease or overgrowth

2) Less serious side effects include:

• Abnormal Hair Growth: Both men and women may develop hair growth in abnormal amounts on the face, chest and arms.
• Nausea and diarrhea
• Tremor: Above 50 % of people develop tremors characterized by shaking. Leg cramps or muscle contractions might also be experienced.

Special precautions before starting cyclosporine:

• A person suffering from any kidney disease, uncontrolled hypertension or cancer are not eligible to take this drug.
• Psoriasis patients who have had certain previous treatments like PUVA, UVB, coal tar, radiation therapy, methotrexate, etc are at higher risk to develop skin cancer.
• Any "live" vaccine taken while you are being treated with cyclosporine will not be effective.
• There are many other medicines like vitamins, minerals, etc. which can cause serious medical problems if you take them together with cyclosporine.
• Do not start using any new medication without informing your doctor. The safest way is to keep a list of all the medicines you use and show this list to the doctor.
• Avoid eating grapefruit or drinking grapefruit juice.

Adverse effects of Cyclophosphamide, Adverse effects of Cyclosporine, Adverse effects of Methotrexate

© 2008 Dr. Rajesh Shah. All rights reserved.

Written & Approved by-

Dr. Rajesh Shah

M.D. (Hom.)