Who Should Not Take Cyclosporine? Symptoms of Psoriasis

Cyclosporine might not be a good choice for you if you have kidneys that are not functioning normally, if you have uncontrolled high blood pressure or if you have an allergy to the drug.Symptoms of Psoriasis

Reasons a Psoriasis Patient Should Not Take Cyclosporine

Drugs and Supplements That Interact with Cyclosporine

non-steroidal anti-inflammatory drugs
antibiotics (erythromycin, clarithromycin, azithromycin, doxycycline)
trimethoprim sulfamethoxazole
immunosuppressive drugs (tacrolimus, melphalan)
oral contraceptives
wararin
St. John's Wort
grapefruit, grapefruit juice

Side Effects Symptoms of Psoriasis

Cyclosporine suppresses the immune system (immunosuppressant), and there are possible side effects that are mainly related to immunosuppression. In addition, kidney toxicity, high blood pressure and potential interaction with other drugs are other risks. Cyclosporine's risks and benefits should be carefully considered before starting the treatment. Side effects are usually reversible if treatment with cyclosporine is stopped.

Common Side Effects of Cyclosporine Symptoms of Psoriasis

There are also some less common but serious side effects that are important to recognize. Many patients are concerned by the reported increased risk of cancer with cyclosporine. For example, lymphoma has been reported in some patients taking cyclosporine. Lymphoma is most commonly seen in patients taking higher doses of medication and has been reported in those who are also on other immunosuppressant medications. It is not clear if cyclosporine is entirely responsible for the increased risk of lymphoma, as these other drugs could also play a role. In addition, certain studies have shown that patients with psoriasis may have an increased risk of lymphoma in general.

An increased risk of skin cancers has also been reported in patients taking cyclosporine, many of whom might have received phototherapy prior to using cyclosporine—thereby increasing the risk of skin cancer. The most common types of skin cancers in patients receiving cyclosporine therapy are squamous cell carcinoma and basal cell carcinoma. Fortunately, both these cancers are highly curable, particularly when detected early. Consequently, if you notice a changing area on your skin or an area that is non-healing, report it to your doctor immediately so that the lesion can be checked and, if necessary, removed. Although there are reasons why a patient taking cyclosporines might develop lymphoma, it is important to recognize that medications which affect the immune system might play a role in the development of such cancers.

What Tests or Follow-ups Are Required While on Cyclosporine?

Your blood pressure will be measured prior to starting cyclosporine, then regularly during the initial and subsequent months of therapy. Blood pressure will be carefully monitored because high blood pressure is one of the side effects of this medication. Blood tests measuring how your kidneys are working will also be performed. This test works by measuring your creatinine, a waste product found in urine. A 25 percent increase from normal blood levels of creatinine can indicate mild kidney damage. This is generally reversible when dosing is decreased or cyclosporine therapy is discontinued. In addition, other blood tests, such as cholesterol and potassium, might be tested at the same time as the kidney tests are taken. Before you start on any other medications, consult your doctor.

Oral Retinoids Symptoms of Psoriasis

Retinoids are man-made (synthetic) drugs derived from vitamin A. There are two types of retinoids used in dermatology: isotretinoin and acitretin. Isotretinoin contains an ingredient related to vitamin A and is mainly used to treat acne. Acitretin is also related to vitamin A but is prescribed by dermatologists to treat psoriasis. Another type of retinoid that is still in clinical research trials is oral tazarotene, which is the systemic form of topical tazarotene used occasionally for treating localized psoriasis.

Acitretin Symptoms of Psoriasis

Before you take acitretin tell your doctor if you are:

Acitretin is used to treat moderate to severe psoriasis that has failed to respond to topical therapies. It is particularly effective for erythrodermic, palmoplantar and pustular psoriasis. When used to treat severe plaque-type psoriasis, patients might experience only a partial improvement, and it can take several months to see any improvement. You might notice a temporary worsening of your condition in the first month of use. In this case, your dose of Acitretin might be increased or used in combination with other treatments, such as topical corticosteroids, calcipotriol or phototherapy.

How Does Acitretin Work? Symptoms of Psoriasis

In psoriasis, the skin cell turnover is accelerated from the normal 28 to 30 days for a cell to mature from the basal layer to be shed, to 3 to 4 days. Acitretin helps to slow that rapid growth and, as a result, it reduces the scaling, redness and thickness seen in the skin of certain psoriasis patients.

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