Cyclosporine Toxicity Symptoms
| By
Cyclosporine is a drug that is available in four forms: intravenous injectable, oral capsule, oral solution and ophthalmic (eye drops). In the injectable and oral forms, cyclosporine is indicated for the prevention and treatment of organ rejection in kidney, liver and heart transplants. As an ophthalmic solution, cyclosporine is used to increase tear production in chronic dry eye due to ocular inflammation. Toxicity can occur as a result of overdose or as an adverse effect from normal doses.
Oral Overdose Toxicity
An overdose of oral cyclosporine manifests as several symptoms, including nausea, vomiting, abdominal swelling and a metallic taste in the mouth. Headaches, increased blood pressure and swelling of the limbs can also occur. Occasionally, the kidney may be compromised, but this resolves when the overdose is treated. Overdose can also cause headaches and abnormal muscle twitching.
Intravenous Overdose Toxicity
Intravenous medication involves direct access into the blood through the lungs. When too much cyclosporine is given by IV, the effects can be deadly, since the blood is immediately flooded with the entire dose. Heart problems and seizures can occur. Also, the kidney as well as other organs of the body might shut down. This is an emergency that might require hospitalization.
Adverse Effect Toxicity
Even when given in appropriate doses, cyclosporine IV, oral or ophthalmic forms can affect the body in several ways. Sudden lung injury, seizure and coma are rare and potentially fatal effects. Other side effects include changes in the chemical composition of the blood, increased triglycerides (fat cells) in the blood, extremely high blood pressure, increased hair growth, kidney damage, muscle wasting and abnormal growth of gum tissue. Visual changes may also occur and is most common with ophthalmic eye formulation.
Treatment of Toxicity
The initial goal is to remove excess amounts of the drug using activated charcoal, a material that binds to all the drugs, allowing them to be eliminated. Other treatment options will depend on the symptoms that are present. For cardiac symptoms, the heart should be monitored using a cardiac monitor. For general changes in the body chemical composition, seizures and renal problems, prescription medications are available to treat the symptoms as well as support the patient. Patients should also be closely monitored during this time and intensive blood work may be necessary. As the drug is eliminated, most of the symptoms will resolve.
Cyclosporine is potent and can be potentially fatal in toxic levels. The best way to avoid toxicity from overdose is to verify doses of cyclosporine prescribed. Also, never take more doses than prescribed, never double up on doses when missed and be sure to inform the physician of all adverse effects.
