Cyclosporine: Showdown, it turns out that I have so many misunderstandings!

Self introduction from "cyclosporine"

I-cyclosporine, is an immunosuppressant commonly used to prevent rejection after multiple organ transplantation, and is also suitable for the treatment of some refractory autoimmune diseases, such as: systemic lupus erythematosus, rheumatoid arthritis , dermatomyositis, psoriasis, Sjögren's syndrome and other diseases

I have two ways of administration, one is oral and the other is intravenous, which can be flexibly selected according to the patient's condition

Twice a day, swallow the whole tablet, but pay attention to the interval of 12 hours between the two doses [2]

The medicine can be taken before and after meals, but it is recommended to take the medicine more than 1 hour before meals or more than 2 hours after meals

Different patients have different physical states, and their ability to absorb drugs is also different.

"It's a three-point poisonous medicine", so it is necessary for you to understand my "temper" (adverse reactions)!According to the package insert of cyclosporine, my adverse reactions are:

Kidney damage (renal insufficiency, renal failure, etc.

Judging from the listed adverse reactions, my "temper" seems to be quite big, but in fact, most patients usually experience vomiting, drowsiness, headache, rapid heartbeat and other symptoms after oral administration of cyclosporine, and only a few patients will Moderate and severe liver and kidney damage, but this damage is reversible [1], don't be too afraid of me~However, in order to prevent my adverse reactions from "accidentally hurting" everyone, it is still recommended that you take the medicine according to the instructions or doctor's instructions during use, and regularly monitor the liver and kidney functions

1.

In the process of using the drug, my adverse reactions may hurt you, but you can't stop the drug at will, or even replace the drug

Cyclosporine interacts with many drugs, such as co-administration with immunosuppressants (tacrolimus) , which may cause excessive immunosuppression, which can lead to increased infection and lymphoma development; co-administration with non-steroidal anti-inflammatory drugs , may promote the occurrence of renal insufficiency [4]

Vaccination during cyclosporine treatment, especially live attenuated vaccines (such as chickenpox vaccine, measles vaccine, leprosy vaccine, hepatitis A vaccine, etc.

In the treatment of rheumatic immune diseases, especially the treatment of severe lupus nephritis, cyclosporine is an effective and rare drug

Self introduction from "cyclosporine"

Self-introduction from "cyclosporine" Self-introduction from "cyclosporine" I - cyclosporine, is an immunosuppressant commonly used after multiple organ transplantation to prevent rejection reactions , and is also suitable for treatment Some refractory autoimmune diseases, such as: systemic lupus erythematosus, rheumatoid arthritis , dermatomyositis, psoriasis, Sjögren's syndrome and other diseases .

My Right " Association" Brochure My Right " Association" Brochure I have two administration methods, one is oral and the other is intravenous, which can be flexibly selected according to the patient's condition

The oral method is: The oral method is:

Twice a day, swallow the whole tablet, but pay attention to the interval of 12 hours between the two doses [2]

Twice a day, swallow the whole tablet, but pay attention to the interval of 12 hours between the two doses [2]

The medicine can be taken before and after meals, but it is recommended to take the medicine more than 1 hour before meals or more than 2 hours after meals
.
In addition, it is recommended that patients take the medicine at a fixed time, such as taking it at 8 o'clock in the morning and 8 o'clock in the evening, to avoid the drug concentration being affected by the change of meal time
.
Different patients have different physical states, and their ability to absorb drugs is also different.
Therefore, during the medication, the doctor will ask the patient to regularly monitor the blood concentration of cyclosporine in the body, determine the dose of the drug, and see if the expected blood drug is achieved.
concentration
.
Monitoring blood drug levels during treatment can help improve the effectiveness of drug treatment and reduce adverse drug reactions, and can also adjust drug doses according to the actual situation of the patient
.

Pay attention! I also have a "temper"

Pay attention! I also have "temper" attention! I also have a "temper" and "it's a three-point drug", so it is necessary for you to understand my "temper" (adverse reactions)! According to the package insert of cyclosporine, my adverse reactions are:

Kidney damage (renal insufficiency, renal failure, etc.
); cardiovascular system damage (such as arterial hypertension ); nervous system damage (including convulsions, headache, tremor, weakness, etc.
); systemic damage (such as fever, asthenia, blood drug concentration increase or decrease, etc.
); gastrointestinal system damage (vomiting, diarrhea, pancreatitis, etc.
), other adverse reactions include hypertension, transplant rejection, thrombocytopenia, abnormal liver function, anemia, rhabdomyolysis,
etc.

Kidney damage (renal insufficiency, renal failure, etc.
); cardiovascular system damage (such as arterial hypertension ); nervous system damage (including convulsions, headache, tremor, weakness, etc.
); systemic damage (such as fever, asthenia, blood drug concentration increase or decrease, etc.
); gastrointestinal system damage (vomiting, diarrhea, pancreatitis, etc.
), other adverse reactions include hypertension, transplant rejection, thrombocytopenia, abnormal liver function, anemia, rhabdomyolysis,
etc.
Vascular hypertension From the adverse reactions listed, my "temper" seems to be quite big, but in fact, most patients usually experience vomiting, drowsiness, headache, rapid heartbeat and other symptoms after oral administration of cyclosporine.
Only A small number of patients will have moderate and severe liver and kidney damage, but this damage is reversible [1], you don't need to be too afraid of me~ However, in order to avoid my adverse reactions "accidentally hurting" everyone, it is recommended that you use During the course of treatment, take the medicine according to the instructions or doctor's advice, and monitor the liver and kidney function regularly
.

Notes about me

Notes about me Notes about me

1.
Do not stop or replace the drug at will

1.
Do not stop or replace the drug at will 1.
Do not stop or replace the drug at will.
During the process of using the drug, my adverse reactions may hurt you, but you cannot stop the drug at will, or even replace the drug
.
With regard to drug withdrawal, the correct approach should be to adjust the dose according to the changes in the patient's condition and efficacy.
If the treatment effect is good, the dose can be gradually reduced, and at the same time, alternative therapy should be used as much as possible, rather than abruptly stopping the drug [2]
.
Regarding the substitution of medicines, it is very dangerous to arbitrarily substitute cyclosporine medicines with different brand names or preparations without the consent of the doctor, which may lead to a decrease in blood concentration and an increased risk of rejection [3] .
If the cyclosporine drug needs to be replaced, the doctor should monitor the patient's blood concentration, serum creatinine, blood pressure and the occurrence of other adverse reactions before replacement .
 

2.
Caution in combination with other drugs

2.
Caution in combination with other drugs 2.
Caution in combination with other drugs Ciclosporine interacts with many drugs, such as combined use with immunosuppressants (tacrolimus) , which may cause excessive immunosuppression and lead to infection opportunities increase and the occurrence of lymphoma ; combined with non-steroidal anti-inflammatory drugs , may promote the occurrence of renal insufficiency [4]
.
At the same time, nephrotoxic drugs, high-potassium foods, high-potassium drugs and potassium-sparing diuretics
should be avoided during medication .
For example, co-administration of lymphoma with immunosuppressants (tacrolimus) and nephrotoxic drugs, high-potassium foods, high-potassium drugs, and potassium-sparing diuretics are combined with non-steroidal anti-inflammatory drugs .

3.
Avoid the use of live attenuated vaccines

3.
Avoid the use of live attenuated vaccines 3.
Avoid the use of live attenuated vaccines during treatment with cyclosporine.
If vaccinated, especially live attenuated vaccines (such as chickenpox vaccine, measles vaccine, leprosy vaccine, hepatitis A vaccine, etc.
) Attenuating the effectiveness of the vaccine may also lead to a decrease in the efficacy of cyclosporine [2]
.
Not only will it weaken the effect of the vaccine, it may also lead to a decrease in the effect of cyclosporine [2]
.

Write at the end:

Written at the end: Written at the end: In the treatment of rheumatic immune diseases, especially the treatment of severe lupus nephritis, cyclosporine is an effective and rare drug
.
Although there may be some side effects during the medication process, as long as you follow the doctor's instructions and monitor the blood concentration during the medication, these adverse reactions are only "a drop in the bucket" compared to the damage to the patient
.
References: [1] Xue Rujun, Zhang Xibao.
Application of cyclosporine in dermatology [J].
Bulletin of Dermatology, 2021, 38(04): 312-319+3.
[2] Cyclosporine [J].
Shanghai Medicine, 2020, 41(S2): 35-36.
[3] Risks of substitution of cyclosporine with different trade names or preparations [J].
Chinese Community Physician, 2010, 26(25): 16.
[4] Chang Xin Yu,Guo Guiming,Liu Yang,Han Lijuan,Che Xiaoping,Fan Zheng.
Analysis of adverse reactions of cyclosporine caused by drug interactions and pharmaceutical care[J].
Journal of Pharmacy Practice,2018,36(04):365-368.


leave a message here