Psoriasis: Adverse effects of Cyclosporine
Cyclosporine is an immunosuppressant drug widely used in post-allogeneic organ transplants such as kidney, liver, or heart to reduce the activity of the patient's immune system.
Use of Cyclosporin leads to a severe flare-up in many cases of Psoriasis: Dr. Shah's experience at Life Force
We have documented a good number of cases where the previous use of Cyclosporin (and such immuno-suppressive medicines) has led to initial improvement. However, on stopping Cyclosporin, the flare-up of Psoriasis is very severe. Here is a case example of a lady who approached us at Life Force on the 14th March 2014. She had used Psorid (Cyclosporin)(100 mg, once a day for a month) in October and which was tapered by the dermatologist. She was then put on Steromom (Mometasone) and Halox (Halobetasol propionate)
ointment. When she approached us for homeopathic treatment on 14th March 2014. As per the guidance of her previous dermatologist, she reduced the use of both the creams and stopped in a month. On 14th April 2014, as you can see in the photo, her skin lesions of psoriasis were under control, "masked", as Dr. Shah says. She was informed that her psoriasis is likely to flare up now, as the effect of Cyclosporin and cortisone is over. It exactly happened as anticipated. As seen in the photo on 14th May 2014, her psoriasis flared up aggressively, all across the body, exactly as foretold.
It must be noted that this is a common experience that previous use of immunosuppressive medicines leads to a flare-up of the disease. The question is "what was achieved by using Cyclosporin?
Photos: temporary improvement after stopping Cyclosporin and Severe flare-up within two months thereafter
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. The 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 face lips, and throat, or difficulty in breathing.
- Seizure (convulsion)
- Tachycardia (fast heart rate), muscle weakness, or pain
- Flu-like symptoms as fever chills and sore throat
- Jaundice presented as yellowing of skin and sclera, dark urine, nausea, 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 is 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 Cortisone, Adverse effects of Methotrexate
Written & Approved by-
Dr. Rajesh Shah
M.D. (Hom.)