Atopica for dogs is a preparation of a drug called cyclosporine which is commonly used to treat the allergic skin condition called atopic dermatitis. It is available in capsule (Atopica) and eye ointment (Optimmune) formulations.
Optimmune cyclosporine eye drops can be used to treat the eye related symptoms of atopic dermatitis such as allergic conjunctivitis (i). As well as having immunosuppressive properties it is a lacrimomimetic (tear substitute).
As atopic dermatitis in dogs cannot be cured its treatment revolves around management and treatments are often required over long periods of time. Cyclosporine is an immunosuppressive calcineurin inhibitor and acts by suppressing cells involved in the inflammatory response which causes the condition (ii).
Atopica cyclosporine capsules should be given at a dose of 5mg/kg/day over an initial dose period of 30 days. A minimum of 4-6 weeks are needed to see an improvement of clinical signs (iii).
Treatment can then be reduced to every other day and subsequently to twice a week and possibly even to even less frequently until a minimum level is achieved where therapeutic effects are still maintained (iv).
Optimmune cyclosporine eye ointment (0.2% cyclosporine) should be used every 12 hours by applying a small strip a quarter of an inch long to the eye being treated(v) . Care should be taken not to touch the eye with the end of the tube when administering the ointment.
As with Atopica time is often needed before improvements are seen from the use of cyclosporine eye treatments.
The most commonly seen side effects of cyclosporine for dogs are gastrointestinal including
- abnormal stools/diarrhoea
but these can be reduced by giving the treatment at appropriate times in relation to food (vi) . These gastrointestinal side effects were mostly seen at the beginning of treatment and generally subsided with time (vii).
Other less common side effects have been seen and these include:
- persistent otitis externa
- urinary tract infection
- gingival hyperplasia
Atopica should not be used in dogs which have a history of cancer or in pregnant or lactating females (viii).
As the mechanism of action is via immunosuppression this is also a possible concern and all animals being treated should be monitored for infections and infestations. Routine monitoring using blood tests and urine analysis should be performed before starting cyclosporine treatments, after 3 months and then every 6 months during treatment (ix).
Side effects of Optimmune eye ointment are generally ocular, although it is thought that most cases are caused because the treatment was unable to properly control the condition being treated. Other side effects include:
- transient hyperemia (increased blood flow to the eye)
- epiphora (excessive tear production)
- mild discomfort of the eye.
A veterinarian should prescribe both Atopica and Optimmune to your dog and you should contact them straight away if your pet experiences any side effects while taking the medication.
Cyclosporine (Atopica) is generally used in chronic cases of atopic dermatitis. It is a good and effective alternative to corticosteroids in some cases of atopic dermatitis treatment as it has fewer unwanted side effects.
Cyclosporine has been shown to be equally as effective as prednisolone in studies looking at the control of atopic dermatitis (x), showing a high response rate in 65-76% of cases (xi).
Due to the slow onset of effects in terms of clinical improvement corticosteroids are often given for a short time at the beginning of treatment to temporarily alleviate symptoms, making the dog more comfortable until the cyclosporine has an effect.
Before using Optimmune cyclosporine eye ointment the eye should be bathed and cleaned using a non-irritant solution, removing any dirt before its application. Once you have applied the ointment to the eye allow your dog to blink and then gently massage the eyelid over the closed eye to help dissipate the ointment.
Use of cyclosporine in the eye should be avoided if the dog has an ulcer as it can prevent healing. Its use should also be avoided if there is the possibility of fungal infection of the eye. If using in conjunction with other eye medications around 5 minutes should be allowed between applying each one.
Although cyclosporine treatment for atopic dermatitis has been shown to have good results it is relatively expensive compared to some other treatment options and cost may therefore be prohibitive.