Cyclosporine (Atopica®) for Dogs

PetMD’s medications content was written and reviewed by veterinary professionals to answer your most common questions about how medications function, their side effects, and what species they are prescribed for. This content shouldn’t take the place of advice by your vet.

What Is Cyclosporine (Atopica®) for Dogs?

Cyclosporine (Atopica®) is a prescription FDA-approved veterinary medication used for the management of itching and inflammation associated with atopic dermatitis (skin issues due to environmental allergies) in dogs and allergic dermatitis in cats.

Cyclosporine is available for dogs in multiple formulations, including oral Atopica® capsules, generic oral solution for dogs including Cyclavance™ and Modulis®, and eye ointment (Optimmune®). Your veterinarian will determine whether this medication is right for your pet. This is called extra-label or off-label treatment because this use isn’t described on the drug label.

Conditions cyclosporine (Atopica®) is used to treat in dogs include:

• Perianal fistulas

• Immune-mediated blood disorders of red blood cells (IMHA) or platelets (IMT)

• Idiopathic chronic hepatitis (a certain type of liver inflammation)

• Sebaceous adenitis

• Inflammation of the blood vessels (vasculitis)

• Diseases of the nose skin (nasal dermatoses)

• Dermatomyositis (an immune mediated condition affecting the skin and muscles)

• Puppy strangles

• Certain types of severe ear infections (otitis externa)

• Keratinization disorders (seborrhea)

• Lupus (SLE)

• Uveodermatologic syndrome (UDS, an immune-mediated condition that affects the skin and eyes)

Cyclosporine (the active ingredient in Atopica®) is FDA-approved for human use under the brand names Gengraf®, Neoral®, and Sandimmune®, and as generic cyclosporine. However, due to differences in dosage and possible side effects, pets should never be given cyclosporine prescribed for humans.

In certain circumstances, your vet may recommend a compounded formulation of cyclosporine. Compounded medications are prescribed if there’s a specific reason your pet’s health can’t be managed by an FDA-approved drug, such as if your pet has trouble taking pills in capsule form, the dosage strength is not commercially available, or the pet is allergic to an ingredient in the FDA-approved medication.

Compounded medications are not FDA-approved. They are created by either a veterinarian or a licensed pharmacist on an individual basis to best suit a patient’s particular needs. You can learn more about compounded medications here.

Cyclosporine (Atopica®) Considerations in Dogs

Atopica® suppresses a dog’s immune system, which may make it harder for a sick dog to fight infection and may increase the risk of cancer.

Atopica® should not be used in dogs with a history of cancer or in dogs who are hypersensitive to it. This medication should be used with caution in dogs with kidney disease and diabetes mellitus.

Atopica® and the generic formulations of cyclosporine should be used with caution in dogs with the MDR1 gene mutation (common in Collies, Shelties and Australian Shepherds). Dogs with this specific gene mutation (also known as ABCB1–1Delta) may have increased sensitivity to certain types of medications including cyclosporine (Atopica®).

Giving Atopica® with certain medications can result in health risks to your pet, so it is important to discuss your pet’s medical conditions and medications, including vitamins and supplements, with your veterinarian.

Atopica® is only approved for use in dogs at least 6 months of age, weighing at least 4 pounds. It is not for use in breeding dogs, pregnant dogs, and lactating females.

Treatment with Atopica® requires close monitoring and supervision by your veterinarian. Before and during your pet’s treatment, your vet will perform blood tests to evaluate their immune system function as well as the effects of the medication on the liver, kidneys, and blood counts.

How Cyclosporine (Atopica®) Works in Dogs

The active ingredient of Atopica® is cyclosporine. Cyclosporine blocks T-cells, a type of white blood cell involved in the immune response. By inhibiting T-cells, cyclosporine helps calm down the immune system when it is inappropriately overreactive. This lowers the immune system’s response, which may increase your pet’s susceptibility to infection and risk of cancer.

Cyclosporine (Atopica®) Directions for Dogs

Follow the directions on the drug label or as provided by your veterinarian.

Do not open or break the capsules.

Your veterinarian may instruct you to give this medication on a consistent schedule at the same time every day.

In dogs, Atopica® is best absorbed on an empty stomach, so your veterinarian may instruct you to either give it at least one hour before a meal, or two hours after a meal.

Your veterinarian may start your dog on daily dosage during their initial treatment period, then, under their supervision, advise you on how to decrease how often you give the medication, so that your pet is taking the lowest effective dose to help relieve their symptoms.

Missed a Dose?

Speak with your veterinarian about what to do if you forget to give a dose of Atopica®.

Generally, they may instruct you to give it when you remember, or if it is almost time for your pet’s next dose, to skip the missed dose and resume your normal dosing schedule. Do not give extra or double doses.

Possible Side Effects of Cyclosporine (Atopica®) in Dogs

Gastrointestinal upset (vomiting, diarrhea, low appetite) is commonly seen in dogs within the first 1-2 days of starting Atopica® but often resolves with time.

Your vet may prescribe anti-nausea medications to help your pet with these symptoms if they occur or recommend freezing cyclosporine capsules for 30 to 60 minutes before administration.

Less common side effects include:

• Low energy (lethargy)

• Bladder infection

• Gum overgrowth (gingival hyperplasia)

• Fever, sneezing, coughing, eye discharge that may indicate infection

• Bacterial skin infection

• Enlarged lymph nodes

Human Side Effects

Atopica® is not used in human medicine. Wear gloves when administering the medication and wash your hands afterward.

People with a known hypersensitivity to cyclosporine should avoid contact with this medication.

The active ingredient in Atopica® is cyclosporine, which is a prescription medication for humans, frequently with dosages different from those prescribed for your pet by a veterinarian. Due to possible side effects, humans should never use medicine dispensed for their pets and pets should not be given any medicine dispensed for a human’s use.

If you accidentally ingest a pet medication, call your physician or the national Poison Control Center hotline at 800-222-1222.

Call Your Vet If:

• Severe side effects are seen (see above)

• Your pet’s condition worsens or does not improve with treatment

• You see or suspect an overdose

• You have additional questions or concerns about the use of cyclosporine (Atopica®)

Cyclosporine (Atopica®) Overdose Information in Dogs

An overdose of Atopica® may cause vomiting, diarrhea, low appetite, kidney damage, or liver damage.

If you suspect an overdose, immediately contact your veterinarian or an animal poison control center. Consultation fees often apply.

Pet Poison Helpline (855) 764-7661

ASPCA Animal Poison Control (888) 426-4435

Cyclosporine (Atopica®) Storage for Dogs

Always confirm storage requirements by reading the prescription label.

Atopica® capsules and oral solution should be stored at controlled temperatures from 59 F to 77 F. Keep the container tightly closed in order to protect its contents from moisture and light.

Compounded medications should be stored according to the compounding pharmacy’s label.

Keep out of reach of children and pets.