Medical Health Encyclopedia

Side Effects. Common and temporary side effects include headaches, gingivitis, joint pain, gout, body hair growth, tremor, and fatigue.

More serious complications may include the following.

• Kidney damage. This is a significant complication and prolonged use always causes some kidney injury.
• High blood pressure (occurring in up to 30% of patients). Some experts advise treating high blood pressure with calcium-channel blockers, since other standard anti-hypertensive drugs may worsen psoriasis. Calcium channel blockers also help prevent kidney problems.
• Unhealthy cholesterol and lipid levels. Patients may need to take cholesterol-lowering agents.
• Abnormalities in the liver.
• Increased risk for infections.
• Skin cancers. Patients who have taken cyclosporine after PUVA therapy have a higher incidence of squamous cell carcinoma. According to a 2003 study, the risk is six times that of the general population. The risks are highest with long duration and previous use of PUVA, methotrexate, or other immunosuppressants.
• Lymphomas. The use of cyclosporine after transplantation has been associated with a higher risk for lymphomas, although whether cyclosporine used for skin diseases poses any higher risk is unknown.
• High levels of calcium and low levels of magnesium. These effects can usually be offset with magnesium supplements and eating potassium rich foods.

To minimize complications of cyclosporine, the dosage is reduced after improvement occurs. Maintenance therapy is usually limited to a year, although some experts believe that a microemulsion form of Neoral (Neoral-Neo) may safe for up to two years. Patients should be monitored regularly for hypertension and signs of kidney or liver abnormalities and evaluated for skin cancers.

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Patients Who Should not Use Cyclosporine. Because the drug suppresses the immune system, people with active infections or cancer should avoid it. Patients with uncontrolled high blood pressure and impaired kidney function should also not use this agent. Cyclosporine therapy for children with psoriasis has not been well-studied.