Cyclosporine for Cats

Cyclosporine for cats is one of the front-line treatments veterinarians use to combat non-flea, non-food allergies in cats. This condition, called atopic dermatitis or atopy, is very common in cats. In fact, one study reported that 12.5% of cats have the condition. (1) 

Cats with atopy have very itchy skin that can result in hair loss, wounds, crusts, and sores. Luckily for them, cyclosporine for cats is often an effective treatment. 

What Is Cyclosporine for Cats?

Cyclosporine for cats is a medication given by mouth that reduces the symptoms of allergic skin disease by suppressing the immune system. It is sold under the brand name Atopica, which was the first nonsteroid medication approved by the FDA to treat allergic skin disease in cats. A generic version of cyclosporine has been approved by the FDA and may become available soon. Some compounding pharmacies can compound cyclosporine for cats, as well.

Is Cyclosporine Safe for Cats? 

Most cats tolerate cyclosporine very well without side effects. Cyclosporine prescribed as a treatment for dermatitis in cats can usually be tapered to less than once daily. However, it is likely to be a long-term and potentially lifelong treatment. 

Cyclosporine is available throughout the United States. You can typically buy it directly from your prescribing veterinarian; and veterinary dermatologists often carry cyclosporine for cats, as well. 

If your finicky feline doesn’t love the flavor of Atopica for cats, ask your veterinarian if a compounded form of cyclosporine in a flavored liquid or another form could help with the administration of the drug. Compounded cyclosporine is considered safe for cats, but should only be used if the cat does not do well with the FDA-approved product.

Cyclosporine isn’t recommended for cats with a history of cancer, cats with feline immunodeficiency virus (FIV), or cats with feline leukemia virus (FeLV). Use with caution in cats who have liver or kidney disease. In some cases, your veterinarian may need to weigh risk versus benefit, which is a conversation you should have together.

What Does Cyclosporine for Cats Look Like?

Cyclosporine oral solution for cats comes as a clear liquid in a small bottle. The dose is pulled up from the bottle using a syringe.

Cyclosporine capsules for cats are not FDA-approved, but capsules could be compounded. Use of the capsules intended for dogs or human medications is off-label. The appearance of capsules may vary based on the compounding pharmacy.

While learning about cyclosporine for cats, you may come across cyclosporine eye drops. Cyclosporine eye drops are used to treat dry eye (keratoconjunctivitis sicca) in dogs and aren’t routinely used in cats. These eye drops will not help with your cat’s allergic dermatitis.

How Does Cyclosporine Work?

Cat cyclosporine reduces the symptoms of allergic dermatitis in cats by acting on the cells of the immune system that regulate allergic reactions. While cyclosporine doesn’t cure allergies, it reduces the inflammation (redness/swelling) and itchiness that come with the allergies.

The medication may need to be given once daily for four to six weeks before you can evaluate whether the drug is working. If symptoms are stabilized, the drug can be tapered according to veterinary instructions.

What Is Cyclosporine Used for in Cats?

In cats, liquid cyclosporine is FDA-approved for controlling feline allergic skin disease (allergic dermatitis or atopy).

Cyclosporine can also be used off-label for several conditions, usually autoimmune conditions. Examples of cat diseases that can be treated with cyclosporine off-label include:

• Chronic stomatitis (inflammation in mouth)
• Feline acquired alopecia (a hair loss condition)
• Pemphigus (autoimmune skin condition)
• Immune-mediated thrombocytopenia (autoimmune destruction of platelets)
• Inflammatory bowel disease

How to Give Cyclosporine to Cats

Most cats prescribed cyclosporine receive the liquid form. The dose is calculated according to the cat’s weight. Initially, the cat will take one dose per day for several weeks. After symptoms have stabilized, the dose may be tapered to every other day or twice weekly. 

Cyclosporine for cats should be administered either with a small amount of food or right after feeding. We recommend that the medication be given at a consistent time each day. If you miss a dose, give the missed dose as soon as you realize it, as long as you do not exceed more than one dose per day.

Some cats may not like the taste of cyclosporine. It can help to give it with food or to follow it with a treat. If your cat won’t take the medication in their food, you can slide the tip of the dropper into the cheek pouch at the corner of their lips and dispense the medication directly into their mouth.

Cyclosporine for Cats Side Effects

The most common side effect of cyclosporine in cats is vomiting, which occurred in around one-third of the cats used in the clinical safety field study. However, the study also showed that cats tend to adjust to the medication and stop vomiting with continued use. (2)

Other cyclosporine side effects in cats include:

• Diarrhea
• Decreased appetite
• Drooling
• Weight loss
• Development of behavioral disorders
• Increased hair growth
• Excessive salivation
• Upper respiratory infection symptoms like sneezing and ocular discharge

Because cyclosporine works by suppressing the immune response, cats on cyclosporine may be more likely to develop infections or tumors. The development of cancer as a side effect of cyclosporine is possible, but rare. As a result, cyclosporine should not be used in cats with a history of cancer or in cats who are already immunosuppressed, such as those with feline immunodeficiency virus (FIV) or feline leukemia virus (FeLV).  

An overdose of cyclosporine is most likely to cause vomiting, diarrhea, and poor appetite. Some cats may have short-lived damage to their kidneys or liver after overdose. If you suspect an overdose of cyclosporine, contact your veterinarian as soon as possible. 

Reactions With Other Drugs and Medications

Cyclosporine can react with other drugs and medications. Some medications increase the levels of cyclosporine in the blood, which could potentially increase the risk of side effects or impact how much cyclosporine a cat needs. Examples of such medications include:

• Antifungal medications like ketoconazole
• Some antibiotics such as metronidazole or enrofloxacin
• Amlodipine, a blood pressure medication

Cyclosporine should be used with caution when used in conjunction with other medications that impact the immune system, such as steroids like prednisolone.

You should review the medications your cat takes with your veterinarian to ensure there will not be drug interactions.

Cyclosporine Dose for Cats 

The cyclosporine dosage for cats is based on their weight. Atopica usually comes with a syringe that shows the dosage to give to your cat based on their weight. Pet parents should follow their veterinarian’s recommendations for dosing their cat.

What if My Cat Misses a Dose of Cyclosporine?

If you forgot your cat’s cyclosporine dose or couldn’t give it on time, you can still give the medication later but should not give it more than once daily. 

Although we recommend that you try to give the medication around the same time each day that you administer, your cat will be alright if the medication is a few hours late. If you completely missed the medication for the day, don’t double up the next day. Simply continue with your normal schedule. 

Cost of Cyclosporine for Cats

The cost of cyclosporine will vary based on your cat’s size. Larger cats will use more per dose, so you will need to purchase the medication more frequently than someone who has a smaller cat. You may also spend more on cyclosporine early in treatment when your cat is receiving it daily. If you can successfully taper your cat’s dosage, you may spend less because the cat will only need it every other day or a few times per week.

The larger bottle is usually more cost-effective, costing less per milliliter than the smaller bottle. The larger, 17-mL bottle of Atopica is usually around $100-150. The bottle may last one to two months, depending on dosage.

Cyclosporine Storage Instructions

Cyclosporine for cats should be kept at room temperature, out of reach of children or other pets. Don’t store cyclosporine in the refrigerator. Once opened, the medication should be used within two months to twelve weeks. According to the manufacturers, cyclosporine should be stored in its original container. 

Resources

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819051/
2. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=47f70173-a1d9-4156-9a7f-0f296e5dd64b&type=display