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A Practical Approach to the Use of Cyclosporine for the Treatment of Psoriasis

Cyclosporine is an immunosuppressant that inhibits production of inflammatory cytokines involved in the pathogenesis of psoriasis. It is a rapid-acting agent that is highly effective for all types of psoriasis. It is intended for use at dosages of 2.5–5 mg/kg/day, either as acute short-term therapy or for continuous use for one to two years at a time in systemically healthy patients. The major adverse effects are nephrotoxicity and hypertension. Blood pressure, baseline creatinine, BUN, Mg2+, K+, Uric acid, CBC, fasting lipid profile, liver enzymes and bilirubin should be obtained before initiating therapy and should be monitored throughout therapy. There are many potential drug interactions, and a thorough drug history should also be obtained before initiating therapy.