Immunological Agent

Recently Answered

• QWhen should I use Restasis eye drops?

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  A Dr. Gary S. Hirshfield, MD , Ophthalmology, answered on behalf of American Academy of Ophthalmology's EyeSmart

  Dry eyes is usually a chronic condition that tends to remain or get worse over time. Restasis works through suppressing inflammation in the glands that make tears, and this inflammation is believed to be a major cause of dry eye. If a patient finds that Restasis is effective, it needs to be used continually to maintain the benefits.

  However, in a moderate dry eye, due to patients' wishes because of the inconvenience and/or expense of chronic medicines, doctors have stopped Restasis after six months to a year of seeing beneficial effects. In many cases the symptoms remain improved for quite some time after stopping the Restasis.

  In a severe dry eye where corneal damage and loss of vision is a possibility, Restasis should be continued indefinitely. Other common treatments for dry eyes include non-preserved lubricant drops, punctal occlusion and omega fatty acid supplementation.

• QHow does Copaxone treat multiple sclerosis (MS)?

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  A Multiple Sclerosis Foundation answered

  Copaxone (glatiramer acetate) is a treatment option for multiple sclerosis (MS). Its exact mechanism of action is unknown. The Copaxone molecule resembles myelin basic protein (MBP). It is hypothesized that the T cells produced in response to Copaxone can suppress the immune attack on myelin, preventing demyelination and axonal damage. Preliminary research also suggests that Copaxone may have some neuroprotective properties, but more research is needed to confirm these findings.

  With Copaxone, injection site reactions are common. Less frequent side effects include dilation of blood vessels, chest pain and a reaction immediately after injection that causes palpitations, shortness of breath and flushing. This generally lasts between 15 to 30 minutes, passes without treatment, and has no known long-term effects.

• QWhat are the side effects of cyclosporine?

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  A Columbia University Department of Surgery answered

  Side effects of cyclosporine include: Tremors, headache, gum swelling, hair growth, fluid retention, high blood pressure, decreased kidney function, hot flashes, diarrhea, nausea/vomiting, rash, increased risk of infection, joint discomfort, leg cramping, decreased magnesium levels, increased potassium levels, increased cholesterol levels.

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• QCan natalizumab for multiple sclerosis increase my risk of skin cancer?

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  A Multiple Sclerosis Foundation answered

  Physicians in Boston have reported two cases of melanoma (skin cancer) that developed in women who were administered Tysabri (natalizumab) to treat their multiple sclerosis (MS). John T. Mullen, MD and two colleagues at Beth Israel Deaconess Hospital, Boston reported the cases in the New England Journal of Medicine.
  
  The melanomas developed early in the course of treatment, but it cannot be confirmed from these case reports that Tysabri caused them. However, the authors advise against treating individuals with Tysabri when there is a personal or family history of melanoma or in patients with atypical moles or ocular nevus, which is a spot on the eye that can develop into melanoma.
  
  Dr. Mullen's team reports that a 46-year-old woman developed a melanoma shortly after receiving her first dose of Tysabri. In a 45-year-old woman with a family history of melanoma, an ocular nevus developed into a melanoma after several doses.
  
  A case of melanoma also appeared in the atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study (which involved 942 individuals with relapsing MS, who received either Tysabri or placebo by IV infusion every four weeks for more than two years) in a patient with a history of malignant melanoma.
  
  "Neurologists who have patients who report a family history of melanoma or have unusual moles should send them to a dermatologist first. Don't just start them on drugs [Tysabri]," said Dr. John Thomas Mullen, co-author of the letter and a surgical oncologist with Beth Israel Deaconess Medical Center in Boston.
  
  Tysabri may have a dampening effect on the immune system that encourages the formation of the potentially deadly skin cancer, the letter stated.
  
  "This new report warrants another dose of cautious observation for Tysabri," adds MSF Medical Advisor Ben Thrower, M.D. "Potential Tysabri patients should be screened for any history of melanoma, as mentioned. One could argue that any prior abnormal tissue growth may make Tysabri use riskier for that patient. The thought is that maybe Tysabri interferes with tumor cell surveillance and one would have to question whether this applies to all cancer types. In our practice, Tysabri is only considered in patients with active MS, who have failed both interferon and glatiramer acetate. This new report means that Tysabri is probably not ready for consideration as a first-line option for relapsing forms of MS."
• QWhat should I know about Prograf before taking it?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Share your entire medical history with your doctor before taking Prograf, which can damage the kidneys. If you have kidney or liver disease, high blood pressure, certain heart rhythm problems, or are taking medications to treat other illnesses, including chemotherapy for cancer, it's important that you and your doctor discuss the benefits and risks of using this immune suppressant drug. Also, tell your doctor if you're planning on becoming pregnant or are breastfeeding. Before using Prograf, your doctor may need to adjust the dose to prevent interaction with other medications that you're taking.
  
• QCan children take Restasis?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Restasis has not been deemed a safe and effective medication for children younger than 16. Your pediatrician will advise you on how and if you should administer this drug to a child. Before prescribing the medication, your doctor will need to know a complete medical history and current medications your child is taking, including over-the-counter medications, supplements, and herbal remedies.

   

• QHow effective is cyclosporine at treating psoriasis?

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  A Dr. Darria Gillespie, MD , Emergency Medicine, answered

  Cyclosporine controls psoriasis for many people. In up to 90%, symptoms greatly improve or clear up completely. It works quickly against severe flare-ups. It also works well for nail and pustular psoriasis. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 
• QHow is cyclosporine used to treat psoriasis?

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  A Dr. Darria Gillespie, MD , Emergency Medicine, answered

  Cyclosporine (Gengraf, Neoral) is a drug that suppresses the immune system. It is taken as a daily pill. It is used most often for people with widespread or disabling psoriasis who do not get relief with other treatments. Cyclosporine is usually given for 3 months or less, and should not be used for more than a year.
   
  Cyclosporine works quickly against psoriasis and cannot be used long-term. So it is often combined with other psoriasis drugs, such as methotrexate or adalimumab. After several weeks (as the other drug reaches full effect), cyclosporine can be reduced and stopped. But people should not have UV light treatment while taking cyclosporine.
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor. 
• QDoes cyclosporine interact with other medications and food?

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  A Dr. Darria Gillespie, MD , Emergency Medicine, answered

  If you are taking any of the following medications, cyclosporine can lead to side effects and should be avoided:

  • aliskiren
  • bosentan
  • cholic acid
  • dabrafenib
  • dronedarone
  • enzalutamide
  • eplerenone
  • a fibric acid derivative
  • fingolimod
  • foscarnet
  • fusidic acid
  • idelalisib
  • imipenem
  • mifepristone
  • mitoxantrone
  • natalizumab
  • pimecrolimus
  • pimozide
  • a potassium-sparing diuretic
  • a protease inhibitor for hepatitis C virus
  • silodosin
  • a statin
  • tacrolimus
  • tofacitinib
  • topotecan
  • a tyrosine kinase inhibitor
  • conivaptan
  • vincristine

  If you are taking any of the following medications, cyclosporine might not be a good option for you:

  • an aminoglycoside
  • amphotericin B
  • an androgen
  • denosumab
  • doxorubicin
  • leflunomide
  • a loop diuretic
  • melphalan
  • methotrexate
  • minoxidil
  • a nonsteroidal anti-inflammatory drug (NSAID)
  • sirolimus
  • a sulfonamide
  • temsirolimus

  If you take cyclosporine, you should avoid St. John's wort. 
  
  This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.