사이클로스포린
Cyclosporine
Cyclosporin A
다른 이름: Optimmune · Restasis · Atopica · Cyclavance · Modulis · Sporimmune · Cyclosporin A · Ciclosporin · Cyclosporine
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
구조화 용량 계산 근거Allergic dermatitis (extra-label)
인증된 수의사 확인 필요
- q24-48h
NA
반드시 함께 고려할 임상 맥락 (3)
- NOTE: Dosages are for cyclosporine (modified), Atopica®, Cyclavance®, Neoral®, or equivalent; these dosages are not interchangeable with Sandimmune® (or equivalent) dosages.
- ■ Consider therapeutic drug monitoring (pharmacokinetic and pharmacodynamic) to assess effectiveness of therapy, particularly when response is poor or when adverse effects occur. Therapeutic drug monitoring can also be considered when changing brands or manufacturers, especially if response to therapy changes in the individual patient. Cyclosporine blood concentrations are not typically monitored when treating atopic dermatitis 93 or inflammatory bowel disease 9 because the blood concentrations were found to not correlate with clinical efficacy, but this may be warranted in some cases. 50
- ■ This medication is considered to be a hazardous drug as defined by the National Institute for Occupational Safety and Health (NIOSH). Talk with your veterinarian or pharmacist about the use of personal protective equipment when handling this medicine.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
사이클로스포린은 곰팡이에서 처음 분리된 고지용성 폴리펩타이드 약물입니다. 수의 안과에서는 반려견의 건성 각결막염(KCS, 안구건조증) 및 만성 표재성 각막염(판누스) 치료의 핵심 약물입니다.
눈물 분비를 촉진할 뿐만 아니라 만성 염증과 관련된 각막 색소 침착 및 육아 조직 형성을 감소시킵니다. 장기간 국소적으로 사용해도 전신적인 면역 억제 부작용 없이 일반적으로 안전합니다.
작용 기전
Cyclosporine is a calcineurin inhibitor. It binds to cyclophilin within T-lymphocytes, inhibiting the enzyme calcineurin → prevents dephosphorylation of Nuclear Factor of Activated T-cells (NFAT) → blocks transcription of interleukin-2 (IL-2) and other inflammatory cytokines.
In the eye, this halts local inflammatory mediator production, arresting self-perpetuating lacrimal adenitis. It also acts as a prolactin analog, fitting onto lacrimal prolactin receptors to directly stimulate tear production. Furthermore, it increases conjunctival mucin stores, improving the overall quality of the tear film.
안전성·주의사항
금기사항
- Feline keratoconjunctivitis sicca associated with active herpes virus infection
- Feline eosinophilic keratitis (historically, though newer evidence varies, the monograph notes it is not promising)
부작용
- Mild ocular irritation upon application
- Aggravation of ophthalmic herpes virus infections (especially in cats)
주의
Important: Discontinuation of therapy usually results in the return of clinical signs of KCS within a few days.
Use with caution in the face of ulcerative keratitis, although it is generally considered safe when concurrent antibiotic therapy is administered. Compounded formulations should be avoided if an approved commercial product (Optimmune) is available and effective.
약물 상호작용
Inhibits cytochrome P450 metabolism of ciclosporin, increasing blood concentrations up to five-fold. Dose reduction (halving dose or doubling interval) is required.
Inhibits cytochrome P450 metabolism of ciclosporin, significantly increasing blood concentrations.
Competitively inhibits enzymes involved in ciclosporin metabolism, increasing serum levels.
Inhibits enzymes involved in ciclosporin metabolism, increasing serum levels.
Increased risk of nephrotoxicity; concomitant use is not recommended.
Increased risk of nephrotoxicity; concomitant use is not recommended.
Increased risk of nephrotoxicity; concomitant use is not recommended.
Increased risk of nephrotoxicity; concomitant use is not recommended.
Increased risk of hyperkalaemia.
Ciclosporin inhibits MDR1 P-glycoprotein, decreasing the efflux of macrocyclic lactones from the blood-brain barrier, potentially resulting in CNS toxicity.
모니터링
- Schirmer Tear Test (STT) after 1 month of therapy, then periodically
- Fluorescein staining to monitor for corneal ulceration
- Resolution of corneal pigmentation and neovascularization
약동학
반감기
흡수
Poor systemic absorption across the GI tract. When delivered topically to the eye, it reaches very low systemic concentrations. Trace levels may be detected in blood but clinical implication is uncertain.
분포
Concentrates locally in the cornea, conjunctiva, and lacrimal glands.
대사
Hepatic (Cytochrome P450 3A4) if absorbed systemically.
배설
Primarily biliary/fecal if absorbed systemically.
과다투여
Systemic toxicity has not been noted in dogs given this drug chronically via the topical ophthalmic route. Even if 100% of the ophthalmic dose were absorbed, it is well below the systemic therapeutic/toxic dose.
제품
제형
- 0.2% ophthalmic ointment
- 0.05% ophthalmic emulsion
- 1% ophthalmic solution (compounded)
동물용의약품
- Cyclosporine Ophthalmic Ointment 0.2% (Optimmune)
인용의약품
- Cyclosporine 0.05% Ophthalmic Emulsion (Restasis)
규제 현황
POM-V classification
POM-V classification
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store at room temperature away from moisture and heat. Keep the tube tightly closed.
보호자 정보
반려동물의 안구건조증 관리
- 인내심이 필요합니다: 눈물 분비량이 눈에 띄게 개선되려면 꾸준히 3~8주 동안 사용해야 합니다. 임의로 약을 중단하지 마세요!
- 평생 치료: 안구건조증(KCS)은 대개 평생 관리해야 하는 질환입니다. 연고 사용을 중단하면 며칠 내에 증상이 재발할 가능성이 높습니다.
- 투여 방법: 소량(약 0.6cm)의 연고를 눈에 직접 짜 넣습니다. 인공눈물을 함께 사용하는 경우, 인공눈물을 먼저 넣고 5~10분 기다린 후 사이클로스포린 연고를 투여하세요.
- 안전성: 이 약물은 눈에 매우 안전하며 스테로이드가 유발할 수 있는 전신 부작용을 일으키지 않습니다.
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