Cyclosporine (Atopica®) for Dogs: Uses and Side Effects

Cyclosporine (Atopica®) is a prescription medication used to manage itching and inflammation associated with atopic dermatitis in dogs. Veterinarians may also prescribe cyclosporine for other immune-mediated conditions in dogs.

Cyclosporine suppresses parts of the immune system, so dogs taking it require veterinary supervision and monitoring.

What Is Cyclosporine (Atopica®) for Dogs?

Cyclosporine (Atopica®) is an FDA-approved prescription veterinary medication used to manage itching and inflammation associated with atopic dermatitis in dogs.

Cyclosporine formulations for dogs include:

• Atopica® oral capsules
• Generic oral solutions, including Cyclavance™ and Modulis®
• Eye ointment (Optimmune®)

Cyclosporine may also be used for allergic dermatitis in cats. Your veterinarian will determine whether cyclosporine is appropriate for your pet.

Extra-label uses in dogs: Veterinarians may also prescribe cyclosporine for uses that are not described on the medication label. This is called extra-label or off-label treatment.

Conditions cyclosporine may be used to treat in dogs include:

• Perianal fistulas
• Immune-mediated blood disorders affecting red blood cells (IMHA) or platelets (IMT)
• Idiopathic chronic hepatitis (a certain type of liver inflammation)
• Sebaceous adenitis
• Inflammation of the blood vessels (vasculitis)
• Diseases of the nose skin (nasal dermatoses)
• Dermatomyositis (an immune-mediated condition affecting the skin and muscles)
• Puppy strangles
• Certain types of severe ear infections (otitis externa)
• Keratinization disorders (seborrhea)
• Lupus (SLE)
• Uveodermatologic syndrome (UDS, an immune-mediated condition that affects the skin and eyes)

Human cyclosporine: Cyclosporine, the active ingredient in Atopica®, is FDA-approved for human use under the brand names Gengraf®, Neoral®, and Sandimmune®, and as generic cyclosporine.

Because dosages and possible side effects differ, pets should never be given cyclosporine prescribed for humans.

Compounded cyclosporine: In certain circumstances, your veterinarian may recommend a compounded formulation if:

• Your pet has trouble taking the commercially available formulation.
• The required dosage strength is not commercially available.
• Your pet is allergic to an ingredient in the FDA-approved medication.

Compounded medications are not FDA-approved. They are created by a veterinarian or licensed pharmacist on an individual basis to best suit a patient's particular needs.

Safety Considerations for Cyclosporine (Atopica®) in Dogs

Atopica® suppresses a dog's immune system, which may make it harder for a sick dog to fight infection and may increase the risk of cancer.

Atopica® should not be used in:

• Dogs with a history of cancer
• Dogs who are hypersensitive to Atopica®
• Dogs younger than 6 months of age
• Dogs weighing less than 4 pounds
• Breeding dogs
• Pregnant dogs
• Lactating females

Atopica® should be used with caution in dogs with:

• Kidney disease
• Diabetes mellitus
• The MDR1 gene mutation (also known as ABCB1–1Delta)

The MDR1 gene mutation is common in Collies, Shelties, and Australian Shepherds. Dogs with this mutation may have increased sensitivity to certain medications, including cyclosporine (Atopica®).

Medication interactions: Giving Atopica® with certain medications can result in health risks. Tell your veterinarian about your dog's medical conditions and all medications, vitamins, and supplements they are taking.

Monitoring: Treatment with Atopica® requires close veterinary monitoring and supervision.

Before and during treatment, your veterinarian will perform blood tests to evaluate your dog's immune system function and the medication's effects on the liver, kidneys, and blood counts.

How Cyclosporine (Atopica®) Works in Dogs

Cyclosporine (Atopica®) works by suppressing an overactive immune response in dogs.

The active ingredient in Atopica® is cyclosporine, which blocks T-cells, a type of white blood cell involved in the immune response. By inhibiting T-cells, cyclosporine helps calm the immune system when it is inappropriately overactive.

Because cyclosporine lowers the immune system's response, it may increase a dog's susceptibility to infection and risk of cancer.

How To Give Cyclosporine (Atopica®) to Dogs

Give cyclosporine (Atopica®) exactly as directed by your veterinarian. Atopica® is best absorbed on an empty stomach.

Administration instructions:

• Follow the directions on the drug label or those provided by your veterinarian.
• Do not open or break the capsules.
• Your veterinarian may instruct you to give Atopica® on a consistent schedule at the same time every day.
• Your veterinarian may instruct you to give Atopica® at least one hour before a meal or two hours after a meal.

Your veterinarian may start your dog on a daily dose during the initial treatment period. Under their supervision, they may then decrease how often the medication is given so your dog receives the lowest effective dose needed to help relieve their symptoms.

Missed a Dose?

If you miss a dose of Atopica®, contact your veterinarian for guidance. Generally, they may instruct you to give it when you remember. If it is almost time for your dog's next dose, they may recommend skipping the missed dose and resuming the normal dosing schedule.

Do not give extra or double doses.

Cyclosporine (Atopica®) Side Effects in Dogs

Gastrointestinal upset, including vomiting, diarrhea, and low appetite, is commonly seen in dogs during the first one to two days after starting Atopica® but often resolves with time.

If these symptoms occur, your veterinarian may prescribe anti-nausea medication or recommend freezing cyclosporine capsules for 30–60 minutes before administration.

Less common side effects include:

• Low energy (lethargy)
• Bladder infection
• Gum overgrowth (gingival hyperplasia)
• Fever, sneezing, coughing, or eye discharge that may indicate infection
• Bacterial skin infection
• Enlarged lymph nodes

Human Side Effects

Atopica® is not used in human medicine. Wear gloves when administering the medication and wash your hands afterward.

People with a known hypersensitivity to cyclosporine should avoid contact with Atopica®.

The active ingredient in Atopica® is cyclosporine, which is also a prescription medication for humans, but human and veterinary doses differ. Humans should never use medication dispensed for their pets, and pets should not be given medication dispensed for human use.

If you accidentally ingest a pet medication, call your physician or the National Poison Control Center hotline at 800-222-1222.

When To Call Your Veterinarian

Contact your veterinarian if:

• Your dog develops severe side effects.
• Your dog's condition worsens or does not improve with treatment.
• You see or suspect an overdose.
• You have additional questions or concerns about cyclosporine (Atopica®).

Cyclosporine (Atopica®) Overdose in Dogs

An overdose of cyclosporine (Atopica®) may cause gastrointestinal upset as well as kidney or liver damage.

Signs and effects of an overdose may include:

• Vomiting
• Diarrhea
• Low appetite
• Kidney damage
• Liver damage

If you suspect your dog has received an overdose, contact your veterinarian immediately or an animal poison control center. Consultation fees may apply.

• Pet Poison Helpline: (855) 764-7661
• ASPCA Animal Poison Control: (888) 426-4435

How To Store Cyclosporine (Atopica®)

Store Atopica® capsules and oral solution at controlled temperatures between 59 F and 77 F (15 C–25 C).

Storage instructions:

• Always confirm storage requirements by reading the prescription label.
• Keep the container tightly closed to protect the medication from moisture and light.
• Store compounded medications according to the compounding pharmacy's label.
• Keep out of reach of children and pets.