Ciclosporin Drug information Ciclosporin is used to treat rheumatoid arthritis, lupus, psoriatic arthritis and other conditions. Ciclosporin should effectively treat • even if it doesn’t seem to your condition and prevent joint be working at first damage. It has been tested and • even when your symptoms has helped many people. However, start to improve (to help keep as with all drugs some people the disease under control). will have side-effects and your Ciclosporin may not be response to treatment needs to suitable for you if: be carefully assessed. This leaflet sets out what you need to know. • you have kidney problems • you have high blood pressure which What is ciclosporin isn’t controlled by medication • you have gout or high levels and how is it used? of urate in your blood Ciclosporin is a type of drug • you’ve had cancer. known as a disease-modifying Your doctor will check your blood anti-rheumatic drug (DMARD). pressure and arrange for you In some conditions, the immune to have a blood and urine test system becomes overactive before you start treatment. and can cause problems in the If ciclosporin isn’t suitable joints and elsewhere in the body. your doctor will discuss other Ciclosporin regulates the immune treatment options with you. system, to limit the progress of autoimmune conditions and potential damage to the joints. Ciclosporin is prescribed to reduce pain, swelling and stiffness in rheumatoid arthritis. It’s also used to treat a number of other autoimmune and inflammatory conditions, Ciclosporin can including psoriatic arthritis and systemic lupus erythematosus (SLE). limit the damage caused to your body Ciclosporin isn’t a painkiller and doesn’t work immediately. It’s a long- by your condition. 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): When and how do I take ciclosporin? Ciclosporin is usually taken in capsule form twice a day. It’s also available as a liquid. This drug can Your doctor will advise you about reduce pain, the correct dose. Usually you’ll start swelling and on a low dose, and your doctor stiffness. may increase it if necessary. The dose you’re given will depend on your body weight and how well your kidneys are working. Possible risks and side-effects Possible side-effects of ciclosporin include a rise in blood pressure and to another brand your doctor may effects on your kidneys. Ciclosporin advise more frequent checks to can sometimes cause increased make sure the levels of drug in your levels of lipids (e.g. cholesterol) in blood remain the same. To improve the blood. You’ll have regular blood side-effects you may be advised to tests and your blood pressure will reduce the dose of ciclosporin. also need to be checked frequently while you’re on ciclosporin. You may You should tell your doctor or be asked to keep a record of your rheumatology nurse specialist if blood test results in a booklet, and you develop any of the following you should take it with you when after starting ciclosporin: you visit your GP or the hospital. • nausea (feeling sick) You must not take • diarrhoea ciclosporin unless you’re • headache having regular checks. • gum overgrowth • tiredness There are different brands of • excess hair growth ciclosporin available and, although • any other new symptoms or the drug itself is the same in all anything else that concerns you. the brands, it may be absorbed differently. Your doctor will try to You should stop ciclosporin and keep you on the same brand if see your doctor immediately if any possible. If it’s necessary to change of these symptoms are severe. You should also see your doctor if you develop chickenpox or shingles or come into contact with someone who has chickenpox or Ciclosporin shingles. These infections can be severe in people on treatments that regulates the affect the immune system such as immune system, ciclosporin. You may need antiviral which can be treatment, and your ciclosporin is overactive in usually stopped until you’re better. some conditions. Grapefruit and grapefruit juice can increase the amount of ciclosporin available in your body and so increase the risk of side-effects. Taking other medicines alongside ciclosporin Vaccinations Ciclosporin may be prescribed If you’re on ciclosporin it’s along with other drugs to treat recommended that you avoid live your condition. However, some vaccines such as yellow fever. In drugs may interact with ciclosporin, certain situations, however, a live so you should discuss any new vaccine may be necessary (for medications with your doctor before example rubella immunisation in starting them, and you should women of childbearing age), in always tell anybody treating you which case your doctor will discuss that you’re taking ciclosporin. the possible risks and benefits • You should only take of the immunisation with you. non-steroidal anti-inflammatory If you’re offered shingles vaccination drugs (NSAIDs) on the advice of (Zostavax) it’s best if you can have your GP or rheumatologist. this before starting ciclosporin as it • You can carry on taking painkillers isn’t usually recommended for people as well as ciclosporin, unless who are already on ciclosporin. your doctor advises otherwise. • Don’t take over-the-counter Pneumococcal vaccine (which gives preparations or herbal remedies protection against the commonest without discussing this first cause of pneumonia) and yearly with your doctor, rheumatology flu vaccines don’t interact with nurse specialist or pharmacist. ciclosporin and are recommended. Alcohol There’s no particular reason to avoid alcohol while on ciclosporin, so it’s fine to drink alcohol in moderation. Fertility, pregnancy and breastfeeding Tell a doctor you’re Current guidelines state that on ciclosporin if ciclosprin can be taken when you’re you’re prescribed pregnant. If you’re planning a another drug or family or if you become pregnant treatment. while taking ciclosporin you should discuss this with your doctor. The drug may pass into breast milk but is barely detectable in babies, so is unlikely to be harmful. You will need to discuss with your doctor whether to take this drug while breastfeeding. Arthritis Research UK Thank you for supporting Arthritis works to improve the Research UK. With your generosity we can keep doing our vital work. quality of life for people To donate visit with arthritis so that www.arthritisresearchuk.org/donate they can say they are in control, independent and recognised. We’re dedicated to funding research into We would like to thank the team of people the cause, treatment and cure of arthritis who contributed to the development of so that people can live pain-free lives. this booklet. It was written by Prof. Ariane Herrick and updated by Prof Kuntal Chakravarty For more expert information visit our and Dr Ian Giles. An Arthritis Research UK website or if you would like to tell us medical advisor, Dr Luke Gompels, is responsible what you think about our booklets email for the content overall. [email protected] or write to the address below. Please note: we have made every effort to ensure that this content is correct at time of Arthritis Research UK publication, but remember that information about drugs may change. This information Copeman House sheet is for general education only and does St Mary’s Gate not list all the uses and side-effects associated Chesterfield with this drug. S41 7TD 0300 790 0400 www.arthritisresearchuk.org @ArthritisRUK /arthritisresearchuk Date published: 2015. Registered charity in England and Wales no. 207711, Scotland no. SC041156. ©Arthritis Research UK 2015 A Company registered in England and Wales. Limited by Guarantee no. 490500. 2245/D-CIS/15-1.