Side-effects

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.