Cyclosporine Ointment

Cyclosporine Ointment
Usage
Cyclosporine ointment is a compounded topical immunomodulator used for the management of inflammatory and immune-mediated skin conditions. It is typically considered when conventional therapies (e.g., topical corticosteroids) are ineffective, not tolerated, or unsuitable for long-term use.
It may be prescribed for:
• Atopic dermatitis (eczema)
• Psoriasis (selected cases)
• Chronic inflammatory dermatoses
• Steroid-sparing therapy, particularly for sensitive areas (e.g., face, skin folds)
• Other practitioner-directed dermatological conditions
Topical cyclosporine provides localised immunosuppression with reduced systemic exposure compared to oral therapy.

Dosage
Dosage and frequency should be determined by the prescribing practitioner based on the severity and location of the condition.
Typical dosing considerations include:
• Apply a thin layer to the affected area once or twice daily, or as directed
• Use the minimum amount necessary to control symptoms
• Apply to clean, dry, intact skin
• Wash hands after application unless the hands are the treatment area
Treatment duration and frequency may be adjusted based on clinical response.

Mechanisms of Action
Cyclosporine is a calcineurin inhibitor that suppresses immune-mediated inflammation.
Its mechanisms include:
Inhibition of calcineurin
Cyclosporine binds to intracellular proteins (cyclophilins), inhibiting calcineurin activity.
Reduction of T-cell activation
This suppresses activation of T-lymphocytes involved in inflammatory skin responses.
Decreased cytokine production
Cyclosporine reduces production of inflammatory cytokines such as interleukin-2 (IL-2).
Local anti-inflammatory effect
Topical application results in reduced inflammation, redness, and itching in affected skin areas.

Contraindications
Cyclosporine ointment should not be used in patients with:
• Hypersensitivity to cyclosporine or any component of the formulation
• Active untreated skin infections (bacterial, viral, or fungal)
• Conditions where local immunosuppression may be inappropriate

Precautions
Cyclosporine ointment should be used with caution in patients with:
• Compromised skin barrier, which may increase systemic absorption
• Chronic or recurrent infections
• Immunocompromised states
Additional considerations include:
• Avoid application to large surface areas to minimise systemic absorption
• Local side effects may include burning, stinging, or irritation
• Avoid excessive sun exposure or UV therapy, as immunosuppressants may increase skin sensitivity
• Monitor for signs of secondary infection
Patients should seek medical advice if they experience persistent irritation, worsening symptoms, or signs of infection.

Storage
• Store below 25°C unless otherwise directed
• Keep the container tightly closed when not in use
• Protect from heat, moisture, and direct light
• Do not freeze unless specifically instructed
• Keep out of reach of children and pets
Patients should follow the specific storage instructions provided on the dispensing label supplied by the pharmacy.