Cyclosporine for ulcerative colitis

Examples

Generic Name Brand Name
cyclosporine Neoral, Sandimmune

How It Works

Cyclosporine is a medicine that weakens or suppresses the immune system, which may help decrease inflammation in the digestive tract.

Why It Is Used

Cyclosporine is used for inflammatory bowel disease (IBD) that has not responded to other medicines.

How Well It Works

Medicines that suppress the immune system have been effective against IBD. Cyclosporine usually is used for ulcerative colitis that does not respond to other medicines. Cyclosporine tends to work more quickly than other immunosuppressive medicines, such as azathioprine or 6-mercaptopurine, during an acute attack of IBD.1

This medicine may be used in severe cases when people do not get better on corticosteroids, but in one study 18% to 43% of people did not improve on cyclosporine.2

Cyclosporine has been shown to reduce the need for surgery in acute attacks of IBD.3 This allows people to try other medicines to suppress IBD symptoms.

Cyclosporine also is used in treating abnormal connections (fistulas) of the intestines in Crohn's disease. In rare cases, cyclosporine may be used in people with Crohn's disease that does not improve with other medicines.

Side Effects

Side effects of cyclosporine include:

  • Kidney problems (temporary decrease in kidney function).
  • Increased risk of infections.
  • Blood sugar problems (diabetes).
  • Increased cholesterol levels.
  • Sleep problems.
  • Headache, mild tremor, or tingling of the fingers and feet.
  • High blood pressure.
  • Increased hair growth.

Rare side effects include:

  • Depression.
  • Allergic reaction.
  • Kidney failure.

When taking cyclosporine, blood pressure and kidney function should be checked regularly.

Talk to your doctor or pharmacist about drinking grapefruit juice while you are taking cyclosporine. Grapefruit juice can increase the level of this medicine in your blood. Having too much medicine in your blood raises your chances of having serious side effects. Regular blood tests can be used to monitor the level of cyclosporine.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Cyclosporine is most effective when given in a vein (IV), so it usually is used in people with severe symptoms who need hospitalization. Oral cyclosporine may not be as effective as the IV medicine in treating IBD or in maintaining remission. But the oral medicine often is used after remission from IV medicine.

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References

Citations

  1. Friedman S, Lichtenstein GR (2006). Crohn's disease. In MM Wolfe et al., eds., Therapy of Digestive Disorders, 2nd ed., pp. 785–801. Philadelphia: Saunders Elsevier.
  2. Sands BE, et al. (2001). Infliximab in the treatment of severe, steroid-refractory ulcerative colitis: A pilot study. Inflammatory Bowel Diseases, 7(2): 83–88.
  3. Collins P, Rhodes J (2006). Ulcerative colitis: Diagnosis and management. BMJ, 333(7563): 340–343.

Last Updated: November 3, 2008

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