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Cyclosporine

PrescriptionCDSCO approved

Calcineurin inhibitor (immunosuppressant)

Last reviewed 19 Apr 2026 · PetCare.AI Editorial Team

Species

Dog, Cat

Brands

4 available

Interactions

6 documented

Formulations

Mechanism of action

Binds cyclophilin to form a complex that inhibits calcineurin, blocking T-cell activation and IL-2 production; provides targeted immunomodulation without myelosuppression

At a glance

Class

Calcineurin inhibitor (immunosuppressant)

Schedule

Prescription

Storage

Store below 25°C; do not refrigerate oral liquid

CDSCO (India)

Vet-approved — 1995-01

Dosing

🐕

Dog

Atopic dermatitis / Perianal fistulae / Immune-mediated diseases

Dose

3–7 mg/kg

Route

Frequency

SID (may reduce to EOD once controlled)

Max dose

400 mg

Duration: Long-term; takes 4–6 weeks for full effect

Keratoconjunctivitis sicca (KCS)

Dose

0.2 % ophthalmic

Route

Topical ophthalmic

Frequency

BID

Max dose

0 mg

Duration: Long-term

🐈

Cat

Allergic dermatitis / Eosinophilic granuloma complex / Stomatitis

Dose

5–10 mg/kg

Route

Frequency

SID

Max dose

50 mg

Duration: Long-term

Formulations

💊

Capsule (modified/microemulsified) — 1

Strength

10mg

Available in India

💊

Capsule (modified) — 3

Strength

25mg

Available in India

Strength

50mg

Available in India

Strength

100mg

Available in India

🧪

Ophthalmic ointment — 1

Strength

0.2%

Available in India

Storage

Store below 25°C; do not refrigerate oral liquid

Safety

Absolute contraindications — do not use

Known hypersensitivity to cyclosporine

Use with caution

History of malignancy
Immunosuppression may promote tumor growth
FeLV/FIV-positive cats
Risk of opportunistic infections
Concurrent ketoconazole/itraconazole
Increases cyclosporine levels (sometimes used intentionally to reduce dose/cost)

Adverse effects

Common

Vomiting

Diarrhoea

Anorexia

Gingival hyperplasia (dogs)

Papillomatosis

Serious

Opportunistic infections (Toxoplasma in cats)

Lymphoma (theoretical long-term)

Nephrotoxicity (rare at veterinary doses)

Monitoring parameters

Clinical responseGI toleranceCyclosporine trough levels (if available)Renal values with chronic useMonitor for papillomas

Interactions

Major — 1

Phenobarbital

major

Phenobarbital induces CYP3A4, dramatically reducing cyclosporine blood levels (up to 75% reduction)

Management: Avoid combination if possible. If unavoidable, significantly increase cyclosporine dose and monitor levels.

Moderate — 5

Ketoconazole

moderate

Ketoconazole inhibits CYP3A4, significantly increasing cyclosporine levels (used therapeutically to reduce cyclosporine dose/cost)

Management: Intentional combination in veterinary practice. Reduce cyclosporine dose by 50-75% when adding ketoconazole. Monitor cyclosporine levels.

Itraconazole

moderate

Itraconazole inhibits CYP3A4, increasing cyclosporine blood levels

Management: Reduce cyclosporine dose when used together. Monitor for nephrotoxicity.

Fluconazole

moderate

Fluconazole inhibits CYP3A4/2C9, increasing cyclosporine levels

Management: Monitor cyclosporine levels and renal function.

Meloxicam

moderate

Both can be nephrotoxic; combined use increases risk of renal impairment

Management: Monitor renal function (BUN/creatinine) when using together.

Terbinafine

moderate

Terbinafine may inhibit CYP3A4 metabolism of cyclosporine, increasing cyclosporine levels

Management: Monitor cyclosporine trough levels. May need to reduce cyclosporine dose by 25-50%.

Brands

International

Atopica

Elanco

Optimmune (ophthalmic)

Merck

India

Cyclomune

Sun Pharma

Sandimmun Neoral

Novartis

FAQs

Frequently asked questions

›What is Cyclosporine?

Cyclosporine is a calcineurin inhibitor (immunosuppressant) used in pets. Binds cyclophilin to form a complex that inhibits calcineurin, blocking T-cell activation and IL-2 production; provides targeted immunomodulation without myelosuppression

›What is Cyclosporine used for in pets?

Cyclosporine is used in veterinary medicine for: Atopic dermatitis / Perianal fistulae / Immune-mediated diseases; Keratoconjunctivitis sicca (KCS); Allergic dermatitis / Eosinophilic granuloma complex / Stomatitis.

›What is the Cyclosporine dose for dogs?

For dogs, Cyclosporine is typically dosed as follows — Atopic dermatitis / Perianal fistulae / Immune-mediated diseases: 3–7 mg/kg PO SID (may reduce to EOD once controlled); Keratoconjunctivitis sicca (KCS): 0.2 % ophthalmic Topical ophthalmic BID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.

›What is the Cyclosporine dose for cats?

For cats, Cyclosporine is typically dosed as follows — Allergic dermatitis / Eosinophilic granuloma complex / Stomatitis: 5–10 mg/kg PO SID. Always consult your veterinarian for a dose tailored to your pet's weight, age, and condition.

›What are the side effects of Cyclosporine?

Common: Vomiting, Diarrhoea, Anorexia, Gingival hyperplasia (dogs), Papillomatosis. Serious (call your vet immediately): Opportunistic infections (Toxoplasma in cats), Lymphoma (theoretical long-term), Nephrotoxicity (rare at veterinary doses).

›Does Cyclosporine need a prescription?

Yes. Cyclosporine is a prescription medication and should only be administered under veterinary supervision.

›When should Cyclosporine not be used?

Do not use Cyclosporine if: Known hypersensitivity to cyclosporine.

References

Textbooks & handbooks

Plumb, D.C. Plumb's Veterinary Drug Handbook. 10th ed., Wiley-Blackwell, 2023.
Vail, D.M., Thamm, D.H., & Liptak, J.M. (eds.). Withrow & MacEwen's Small Animal Clinical Oncology. 6th ed., Saunders/Elsevier, 2020.
Riviere, J.E., & Papich, M.G. (eds.). Veterinary Pharmacology and Therapeutics. 10th ed., Wiley-Blackwell, 2018.
National Research Council. Nutrient Requirements of Dogs and Cats. National Academies Press, Washington DC, 2006.
The Merck Veterinary Manual. Merck & Co., Online edition. https://www.merckvetmanual.com/

Clinical guidelines & consensus

Fletcher, D.J., Boller, M., Brainard, B.M., et al. "RECOVER Evidence and Knowledge Gap Analysis on Veterinary CPR." Journal of Veterinary Emergency and Critical Care, 2012;22(S1):S102–S131.
American Animal Hospital Association. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. AAHA Press.

Journals & peer-reviewed studies

Hogan, D.F., Fox, P.R., Jacob, K., et al. "Secondary prevention of cardiogenic arterial thromboembolism in the cat: The FAT CAT study." Journal of Veterinary Cardiology, 2015;17(Suppl 1):S306–S317.
Boswood, A., Häggström, J., Gordon, S.G., et al. "Effect of Pimobendan in Dogs with Preclinical Myxomatous Mitral Valve Disease and Cardiomegaly: The EPIC Study — A Randomized Clinical Trial." Journal of Veterinary Internal Medicine, 2016;30(6):1765–1779.
ASPCA Animal Poison Control Center. Toxicology and Poison Management Guidelines. American Society for the Prevention of Cruelty to Animals. https://www.aspca.org/pet-care/animal-poison-control

Regulatory & approvals

Central Drugs Standard Control Organisation (CDSCO), Government of India. Veterinary Drug Approval Registry, 1969–2026. Directorate General of Health Services. https://cdsco.gov.in/

Databases

Washington State University, College of Veterinary Medicine. Veterinary Clinical Pharmacology Laboratory (VCPL) — MDR1 Multidrug Sensitivity Database. https://vcpl.vetmed.wsu.edu/

Educational reference only

This information is provided for educational purposes and is not a substitute for professional veterinary advice, diagnosis, or treatment. Always consult a qualified veterinarian before administering any medication to your pet. Find a vet near you →

Related medicines

Other medicines in the same class (Calcineurin inhibitor).

Tacrolimus (Ophthalmic)

Binds to FKBP-12, forming a complex that inhibits calcineurin phosphatase, thereby blocking T-lymphocyte activation and cytokine production (IL-2, IL-4). Suppresses local immune-mediated inflammation in KCS.

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