免疫抑制剂环孢素的作用与副作用

英文原文摘自美国约翰霍普金森大学狼疮中心。本人翻译谨做参考，请遵医嘱
Cyclosporine is a more potent immunosuppressive medication that works by blocking the function of cells in your immune system called T-lymphocytes, or “T-cells.” Like other immunosuppressives, it was originally used to prevent the immune systems of patients with transplanted kidneys from rejecting the transplanted organs. It is now also prescribed for people who suffer from inflammation of the kidney caused by lupus, otherwise known as lupus nephritis. However, cyclosporine can be toxic to the kidneys, so use of this medication is usually reserved for cases in which a person’s lupus does not respond to other immunosuppressive medications like Cellcept. Cyclosporine is also prescribed for people with severe psoriasis, a skin condition that can also cause pain and swelling of the joints, and it can be helpful in reducing some of the pain, swelling, and stiffness associated with lupus arthritis.

环孢霉素是一种更有效的免疫抑制药物，它的作用机理和其它免疫抑制剂一样是通过阻断免疫系统的T细胞也称为淋巴细胞的功能,它最初是用来防止肾移植患者的免疫系统对移植器官的排斥。现在还用来治疗由红斑狼疮引起的肾炎或称为狼疮肾炎。然而,环孢霉素可以有肾毒性,因此使用这种药物通常是对那些用其它免疫抑制剂比如骁悉不起作用的狠疮肾炎患者。环孢霉素也用来治疗严重的牛皮癣,或者由于皮肤病导致的关节疼痛和肿胀,并且它可以帮助减少与狠疮关节炎有关的一些疼痛,肿胀,僵硬。
The starting dose of cyclosporine depends on your body weight (usually 2.5 milligrams [mg] per kilogram [kg] per day). The dose is then increased depending on how well the medication works for you and how well your body tolerates the drug. Cyclosporine comes in 25 and 100 mg tablets, and patients usually end up taking 75 or 100 mg per day. You may notice some reduction in pain and swelling after about a week of taking the medication, but its full effects are usually not felt for about 3 months.
环孢霉素的起始剂量取决于你的体重(通常是2.5毫克(mg)每天每千克(公斤))。然后增加剂量取决于药物起作用的状态和你的身体的耐受度。环孢霉素有25和100毫克片剂,患者通常服用75或100毫克每天。你可能会注意到服用大约一星期后会减少疼痛和肿胀,但其全面有作用通常大约要3个月。
Cyclosporine can cause some side effects. About 25% of people taking cyclosporine develop high blood pressure (hypertension). In addition, because cyclosporine can be tough on the kidneys, it can cause a substance called uric acid to build up in the blood (a state known as hyperuricemia). Sometimes this buildup of uric acid can cause gout, a condition that causes intense swelling in one of the joints, often the the big toe. If you already have gout, your condition may worsen while taking cyclosporine. Fortunately, many of these side effects go away as treatment with cyclosporine is reduced or stopped, so your doctor can work with you to adjust your dosage if you begin to experience these problems.

环孢霉素可能会导致一些副作用。约有25%的人服用环孢霉素患高血压(高血压)。此外,由于环孢霉素会损伤肾脏,它会导致一种物质叫尿酸在血液中积聚起来(状态称为高尿酸血)。有时这种累积的尿酸会导致痛风,会导致一种强烈关节肿胀,尤其大脚趾。如果你已经有痛风,你的情况在服用环孢素后可能恶化。幸运的是,许多这些副作用会消失随着环孢霉素治疗剂量的减少或停止,所以如果你有这些问题你的医生可以与你合作来调整剂量。
Other common side effects include headaches, stomach pain (including dyspepsia, a gnawing or burning pain in the pit of your stomach accompanied by bloating), vomiting, diarrhea, and swelling in your hands or feet. Less common side effects include tremors (unintentional muscle movements), increased hair growth, muscle cramps, and numbness or tingling in your hands and feet (a condition known as neuropathy). Some people may also experience swelling of the gums while taking cyclosporine. Be sure to brush and floss regularly; this routine may alleviate some of this swelling.

其他常见的副作用包括头痛、胃痛(包括消化不良、溃疡或灼痛同时伴有胃肿胀),呕吐,腹泻,手或脚肿胀。不常见的副作用包括颤抖(无意的肌肉运动),毛发的生长,肌肉抽筋、麻木或手脚刺痛（一种称为神经病变的疾病)。有些人服用环孢霉素后还可能出现牙龈肿胀。一定要经常刷牙和使用牙线;这样做可以缓解肿胀。
Cyclosporine may increase your risk of developing certain types of cancer, including skin cancer. For this reason, you should coordinate regular skin exams with your doctor. In addition, try to stay out of the sun and make sure to wear sunscreen when you do go outside.

Do not eat grapefruit or drink grapefruit juice while taking cyclosporine. Grapefruit increases the amount of cyclosporine that is absorbed by your body.



环孢霉素可能增加你患某些癌症的风险,包括皮肤癌。出于这个原因,你应该定期配合你的医生做定期皮肤检查。此外,尽量远离太阳,确保当你外出时涂抹防晒霜。

服用环孢霉素期间不要吃柚子或者喝柚子汁。柚子可以增加被你身体吸收的环孢霉素的含量,

Like other immunosuppressive medications, cyclosporine increases your risk of infection, so make sure to wash your hands and stay away from people who may be sick. Notify your doctor at the first sign of any illness. In addition, tell your doctor if you plan to have any vaccines or surgeries, since both can pose risks for people taking immunosuppressive medications.

像其他免疫抑制药物,环孢霉素会增加感染的风险,所以一定要洗手,远离生病的人。一旦有任何疾病迹象立刻通知你的医生。另外,告诉你的医生如果你计划接种疫苗任何疫苗或手术,因为这些会增加服用免疫抑制药物的病人的风险。

Cyclosporine can cause serious complications during pregnancy such premature labor and high blood pressure and fluid retention in your baby, so you should not take cyclosporine if you are pregnant or may become pregnant. Also, do not take cyclosporine while breast-feeding, since it can be passed to your baby through breast milk.

Cyclosporine interacts with certain drugs, so be sure to notify your doctor of any medications you may be taking, including prescription and over-the-counter drugs, supplements, and vitamins. Drugs that may interfere or interact with cyclosporine include:



怀孕期间服用环孢霉素可能引起严重的并发症和早产，高血压和在你的宝贝体内液体潴留等,所以如果你怀孕或者准备怀孕你不应该服用环孢霉素，也不要在服用环孢霉素时母乳喂养,因为它可以通过母乳传递给你的宝宝。

环孢霉素与某些药物相互作用,所以一定要通知你的医生任何你可能服用的药物,包括处方和非处方药,补充剂和维生素。可能与环孢霉素相互影响的药物包括:

Heart and blood pressure medications: diltiazem (Cardizem, Tiazac), nicardipine (Cardene), verapamil (Calan, Covera-HS, Isoptin, Verelan), “potassium sparing diuretics” amiloride (Midamor), spironolactone (Aldactone) and triamterene (Dyrenium)
Cholesterol lowering medications: lovastatin (Mevacor) and simvastatin (Zocor)
Antibiotics and antifungals: clarithromycin (Biaxin), erythromycin, naficillin, fluconazole (Diflucan), intraconazole (Sporanox), ketoconazole (Nizoral), and rifampin (Rifadin, Rimactane)
Anti-seizure (anti-epileptic) medications: carbamazepine (Tegretol), phenobarbital (Solfoton), and phenytoin (Dilantin)
Antidepressants: nefazadone (Serzone) and the selective serotonin reuptake inhibitors (SSRIs) such as paroxitine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft)
Human immunodeficiency virus (HIV) protease inhibitors: indinivir (Crixivan), saquinavir (Fortovase, Invirase), ritonavir (Norvir), and nelfinavir (Viracept)
Others: allopurinol (Lopurin, Zyloprim), bromocryptine (Parlodel), androgens (male hormones), estrogens (female hormones), danazol (Danocrine), metoclopramide (Reglan), methylprednisolone, octreotide, ticlopidine (Ticlid), cimetidine (Tagamet), methoxsalen (Oxsoralen), coal tar (Balnetar, Zetar), trioxsalen (Trisoralen)
Be sure to tell your doctor if you are taking any of these medications.

心脏和血压的药物:地尔硫卓(Cardizem Tiazac)nicardipine(Cardene),维拉帕米(•卡兰从Isoptin Covera-HS Verelan),保留钾利尿剂“阿米洛利(Midamor),螺内酯(螺内酯)和氨苯蝶啶

(Dyrenium) 降低胆固醇的药物:洛伐他汀(洛伐他汀)和辛伐他汀

(辛伐他汀) 抗生素和抗真菌:克拉霉素(Biaxin),红霉素,naficillin,氟康唑(Diflucan)intraconazole(毛),酮康唑(Nizoral)和利福平(Rifadin Rimactane)

抗癫痫药物(抗癫痫):卡马西平()、苯巴比妥(Solfoton)和苯妥英(狄兰汀) 奈法唑酮抗抑郁药:(Serzone)和选择性5 -羟色胺再摄取抑制剂(SSRIs)如paroxitine(帕罗西汀),氟西汀(百忧解),和舍曲林(左洛复)

人类免疫缺陷病毒(HIV)蛋白酶抑剂:indinivir(Crixivan)saquinavir(Fortovase Invirase),例如(Norvir)和奈非那韦(Viracept) 其他:别嘌呤醇(Lopurin Zyloprim)bromocryptine(Parlodel)、雄激素(雄性激素),雌激素(雌性激素)、达那唑(Danocrine),胃复安(灭吐),甲基强的松龙,octreotide,ticlopidine(Ticlid)、甲氰咪胍泰胃美,methoxsalen(Oxsoralen)、煤焦油(Balnetar Zetar)trioxsalen(Trisoralen) 一定要告诉你的医生如果你正在服用这些药物。