side-effects
Last reviewed 01/2018
Treatment with cyclosporin has two major side-effects. The first is infection, the second is nephrotoxicity. Other unwanted effects, notably malignancy, are rarer.
- nephrotoxicity:
- this is minimal at doses less than 2.5 mg/kg/day
- pathological changes occur in blood vessels and nephrons
- the damage is usually reversible on withdrawal of the drug
- renal function should be monitored 2-weekly for the first 3 months, if all is normal monitoring should continue monthly
- if creatinine rises by 30% above the baseline in two consecutive samples then the dose of cyclosporin should be reduced
- if the creatinine levels do not return to normal within a month then treatment should be stopped
- hypertension:
- blood pressure should be monitored
Other possible side effects include:
- hypertrichosis
- oedema
- hepatotoxicity
- nausea and vomiting
- central nervous system disorders e.g. confusion, tremor and paraesthesiae
- there is an increased risk of skin tumours, lymphomata and solid tumours
- hyperkalaemia
- thrombo-embolic complications, thrombocytosis
- effect on glucose tolerence - reduction in insulin production and impaired glucose tolerence
- other adverse effects include hyperuricaemia, myopathy, infections and gum hyperplasia
Reference:
- (1) Drug and Therapeutics Bulletin 1994; 32(9): 66-70.
- (2) Italia JL et al. Disease, destination, dose and delivery aspects of ciclosporin: the state of the art.Drug Discov Today. 2006 Sep;11(17-18):846-54.