CYCLOSPORIN
Today, we want to learn another drug that is commonly asked in MRCP. Cyclosporin is a fungal peptide( discovered in 1972) with potent immunosuppressive activity. It acts to block transcription of mRNA for IL-2 and other proinflammatory cytokines, thereby inhibiting T cell proliferation.
Indications of Cyclosporin
Mainly for immunsuppresion after organ transplant
Rheumatoid arthritis
Auto-immune disease such as SLE
Psoriasis
Inflammatory Bowel Disease
Common side effects
Hypertension and diabetes
Excessive hair growth
Tremor
Nephrotoxicity
Hepatotoxicity
Gum hypertrophy
Electrolyte imbalance
Common interaction
It is mainly excreted by the liver in bile (about 90%), therefore cyclosporin level is increased by drugs which compete with c-p450 liver enzymes ( remember about erythromycin and cimetidine). For doctors, remember that grapefruit juice increases the level of cyclosporine.
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