Cyclosporine Tips for Atopy
Oral cyclosporine is effective in managing pruritus in 60-75% of atopic dogs. This drug can also be used off-label in cats. To increase the likelihood that your patients will respond to cyclosporine, please consider the following recommendations:
Two month trial
Do a two month trial with a 5mg/kg dose given once daily. If there is no response after 2 months, then the patient is a cyclosporine failure. If the patient responds, then follow the tapering suggestions listed below.
Some pets require daily therapy; however, we recommend attempting to reduce the dose using the guidelines below:
Once the two month trial is completed, try decreasing to every other day therapy. Monitor for increased pruritus for ONE MONTH because some pets have delayed pruritus flares at 3-4 weeks after the dose reduction.
If pruritus flares, return to daily dosing until pruritus is controlled. Then try eliminating only 1-2 doses per week or try decreasing the daily dose by 25%. Taper in monthly intervals until you find the lowest cumulative weekly dose that works.
Vomiting side effect
About 25% of dogs vomit during the first month of therapy and then the problem resolves on its own. Most of the dogs with this side effect vomit only 1-2 times per day and do not feel bad. Cats rarely vomit with this drug.
To decrease the chance of vomiting:
- First, give the drug with a meal.
- Second, give metoclopramide before the meal and medication.
- Third, freeze the capsules.
Diarrhea side effect
Diarrhea occurs in some patients. This side effect does not usually resolve on its own, but it can be reduced by adding fiber to the diet.