Ciclosporin is an immunosuppressant which decreases clonal proliferation of T cells by reducing IL-2 release. It acts by binding to cyclophilin forming a complex which inhibits calcineurin, a phosphatase that activates various transcription factors in T cells

Adverse effects of ciclosporin (note how everything is increased - fluid, BP, K+, hair, gums, glucose)

• nephrotoxicity
• hepatotoxicity
• fluid retention
• hypertension
• hyperkalaemia
• hypertrichosis
• gingival hyperplasia
• tremor
• impaired glucose tolerance
• hyperlipidaemia
• increased susceptibility to severe infection

Interestingly for an immunosuppressant, ciclosporin is noted by the BNF to be 'virtually non-myelotoxic'.

Notable interactions

• cannabidiol: may increase the concentration of ciclosporin BNF

Indications

• following organ transplantation
• rheumatoid arthritis