Cyclosporine - Ophthalmic

By Rania Gollakner, BS, DVM, MPH

What is cyclosporine ophthalmic ointment?

Cyclosporine ophthalmic ointment (brand names Optimmune®, Restasis®) is an immunosuppressant used in the treatment of eye diseases suspected to be immune-related, including keratoconjunctivitis sicca (KCS) in dogs, and other inflammatory conditions of the eye.

Its use for treating inflammatory conditions of the eye other than KCS is considered ‘off label’ or ‘extra-label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully.

(For information on cyclosporine given orally, see the handout "Cyclosporine - Oral".)

How is cyclosporine ointment given?

Cyclosporine comes as an ophthalmic ointment but may sometimes be compounded into a higher concentration ophthalmic solution for pets not responding to the ointment. It is important that you administer this drug to your dog’s eye in the exact amount that it has been prescribed. Ointment usually needs to be applied every 12 hours.

It is important to avoid contamination of the eye medication’s applicator tip. For tips and instructions on administering eye drops and eye ointments, see handouts "Applying Eye Drops to Dogs" and "Applying Eye Ointments to Dogs".

Wait 5-10 minutes before applying any other medications to the eye. Use eye drops before ointments to allow the drops to absorb into the eye.

It is important to remember that it may take days to weeks to notice improvement. Do not stop giving the medication without asking your veterinarian.

What if I miss giving my pet the medication (or my shipment is late)?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time. After that, return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects may include mild burning, stinging, irritation, or redness of the eyes, eyelid spasm, or loss of hair around the eye.

More serious side effects include difficulty breathing or swelling of the throat, which could indicate an allergic reaction. Contact your veterinarian immediately if your pet shows these signs.

Signs of immune system suppression, including weakness, tiredness, fever, infections, and unusual bruising or bleeding, must be reported to your veterinarian immediately.

Are there any risk factors for this medication?

This drug should not be used in patients that are allergic to it or drugs like it, or in pets with eye infections caused by a virus or fungus.

This drug should be used with caution in animals that are pregnant or nursing or animals that are on other immune suppressing drugs.

 

Are there any drug interactions I should be aware of?

Other drugs can interact with this medication so be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your veterinarian will monitor for adequate tear production and inflammation of the eye.

How do I store cyclosporine ointment or ophthalmic solutions?

The ophthalmic ointment (Optimmune®) should be stored at controlled cool room temperature away from moisture and sunlight. Handle the tube gently to prevent the metal tube from cracking and leaking.

Cyclosporine solutions should be stored at room temperature. Do not refrigerate or freeze. Discard if a color change occurs or if particles are observed in the solution.

What should I do in case of emergency?

An overdose of eye medication is unlikely, but side effects or toxic effects could occur if your pet eats the medication. If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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