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cyclosporine is immuno-modulating rather than
 
cyclosporine is immuno-modulating rather than
 
immunosuppressive (Figure 2).
 
immunosuppressive (Figure 2).
Cyclosporine is rapidly absorbed and distributed.
+
 
Bioavailability varies from 15-60% in individual
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dogs and is not affected by food. There is little
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correlation between trough levels and efficacy, and
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dose adjustments are made according to the clinical
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response rather than monitoring plasma levels.
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Metabolism is via the cytochrome P450 system.
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Numerous drugs can decrease metabolism, notably
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itraconazole and ketoconazole, which increases
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plasma concentrations, efficacy and the likelihood of
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adverse effects (Figure 3). Phenobarbital increases
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metabolism and decreases plasma levels.
   
Cyclosporine is administered for canine AD at a
 
Cyclosporine is administered for canine AD at a
 
dose of 5 mg/kg once daily. Controlled studies
 
dose of 5 mg/kg once daily. Controlled studies
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management program can be more cost-effective
 
management program can be more cost-effective
 
than relying on it alone.
 
than relying on it alone.
 +
 
The effect on intradermal testing and serology is
 
The effect on intradermal testing and serology is
 
thought to be minimal, although the data is sparse.
 
thought to be minimal, although the data is sparse.
 
Anecdotal data suggests that cyclosporine does
 
Anecdotal data suggests that cyclosporine does
 
not affect the response to ASIT any more than
 
not affect the response to ASIT any more than
glucocorticoids although controlled studies have
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glucocorticoids  
not yet been performed.
+
 
 
Cyclosporine is well tolerated by the majority of dogs.
 
Cyclosporine is well tolerated by the majority of dogs.
 
Transient anorexia and vomiting are the most likely
 
Transient anorexia and vomiting are the most likely
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however, the risk appears to be very small and most
 
however, the risk appears to be very small and most
 
atopic dogs experience fewer secondary infections
 
atopic dogs experience fewer secondary infections
following treatment. Feline and human patients on
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following treatment. Inhibition of
long term treatment have a small risk of developing
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lymphoma and cutaneous neoplasms. Lymphoplasmatoid
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dermatitis has been seen following
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doses >20 mg/kg and there is a single case report
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of lymphoma in an older dog following treatment
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for anal furunculosis. These have, however, not
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been reported in atopic dogs (11). Inhibition of
   
T-helper cell function and β-cell activation could
 
T-helper cell function and β-cell activation could
affect the response to vaccination. Some authors
+
affect the response to vaccination.-->steroids  Some authors
 
advocate withdrawing treatment for up to two
 
advocate withdrawing treatment for up to two
 
weeks either side of vaccination, although this
 
weeks either side of vaccination, although this
will lead to worsening of the skin condition. The
+
will lead to worsening of the skin condition.
pros and cons for each individual case should
  −
be discussed with the owner.
      
====Phytopica™====
 
====Phytopica™====
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