Atopica for dogs - does the generic cyclosporine work? Follow up question -

[catzndogz22]

Allergy season is starting early for my poor lab mix, Mojo. Yes, he is already taking fish oil and has been for years. We’ve tried benedryl, zyrtec, and clemestine with very limited success. I’d really prefer to avoid steroids, if at all possible.

We went to the vet on Monday and discussed trying a combination of Atopica and Ketoconazole. Getting it through the veterinarians office would cost about $250 per month. :eek: If I get them online and use the generic cyclosporine instead of Atopica, the cost comes down to about $140 per month. Still :eek: but a lot better.

Does anybody have any experience with cyclosporine? Did it help? If not, did the brand name Atopica work better?

I’m open to other suggestions for an itchy allergy-suffering dog.

[tarynls]

I do have experience with both Atopica and generic cyclosporine. The veterinary dermatologist wanted to try the brand-name Atopica first for one month to make sure it worked with the “real stuff”. It did, and I’ve been getting the generic from Heartland Vet Supply (I get 100mg capsules, a bottle of 30 for $89.95), with the same results & free shipping.

We were advised that cyclosporine can cause gastric upset, vomiting/diarrhea being the most common side effects. We were also told the capsules should be given one hour before or two hours after a meal for best medication absorption.

http://www.heartlandvetsupply.com/p-2647-cyclosporine-modified-capsules.aspx

FYI, your vet’s office should give you a rebate coupon for the “real” Atopica if you choose to try it first. In my case, I bought 4 boxes of 100mg capsules and received a rebate of $60.00.

[catzndogz22]

Thank you, tarynls! All great info and it looks like Heartland has better prices that Valley Vet.

Did you have any problems with gastric upset? Mojo rarely vomits, but he does often have loose stools.

[tarynls]

I did not have any issues with loose stools or diarrhea. This dog is also a Lab mix, 88 lb, also prone to loose stools and allergic to every single meat protein on the planet (among other things).

We sort of weaned him onto the med - started off on 100mg per day for a week, then 200mg per day for 3 weeks.

Then vet recheck - he responded amazingly well to the medication so he’s now on 100mg on Mon, Weds, Fri, Sun and 200 mg on Tues, Thurs, Sat. Hoping to reduce that to 100mg daily at next recheck (3 months).

Heartland does have great prices and their ordering process is easy as well. I set up an account ahead of time, placed a pending order & printed out the vet order form.

Filled in my info on the form for the vet (including pending order number) and vet faxed it. I had it in a few days.

The refill order was even faster - I had the medication the day after I ordered it. Not bad considering I’m in NJ and they’re in Nebraska.

[Scaredacoops]

My late JRT was on Atopica for several years. I didn’t even know there was a generic. Her allergy season was October thru March and she only took it during that time. I fiddled with the dosage and how often I gave it to her. I found that giving it to her about 3 times a week actually worked for her. I’m not so sure it didn’t cause her lymphoma. There are a lot of discussions across the internet about it. An itchy dog can be really miserable though.

[tarynls]

Scaredacoops - I wonder if the possibility of cancer is the reason the dermatologist says we’ll be reducing the cyclosporine dosage throughout the year & he hopes we can get our dog off the medication approx. a year after starting it.

The derm vet also wants our dog on the least possible dose that is effective.

[SquishTheBunny]

I dont have any expeience with the generic, but I do know Atopica does offer a rebate program (ideal for dogs on it long term). Maybe something to ask your vet about? Now I cant remember the details, but I think its 3rd or 4th box free?

[tarynls]

[QUOTE=SquishTheBunny;6896824]
I dont have any expeience with the generic, but I do know Atopica does offer a rebate program (ideal for dogs on it long term). Maybe something to ask your vet about? Now I cant remember the details, but I think its 3rd or 4th box free?[/QUOTE]

Atopica does have a rebate program. You get a coupon for every two boxes you get & submit it online. In my case, I purchased 4 boxes and received $15 back per box (100mg capsules).

[catzndogz22]

[QUOTE=Scaredacoops;6896703]
My late JRT was on Atopica for several years. I didn’t even know there was a generic. Her allergy season was October thru March and she only took it during that time. I fiddled with the dosage and how often I gave it to her. I found that giving it to her about 3 times a week actually worked for her. I’m not so sure it didn’t cause her lymphoma. There are a lot of discussions across the internet about it. An itchy dog can be really miserable though.[/QUOTE]

Ugh. I guess I should have known to do more research. My “lesson-learned-the-hard-way” happened last fall when Mojo’s sister, who was the greatest dog ever, died after a 4 day course of rimadyl turned her liver and kidneys into jello. (That’s another thread for another time.) The whole thing was a horrible heart-breaking experience and after that, I vowed that I’d never again give any pet a prescription drug without thoroughly researching it first. Human drugs get shelved if the adverse reactions are out of line. Our pets don’t have nearly that level of protection and the veterinarians who treat them seem to buy the drug company’s pitches hook, line, and sinker.

I’ll have to reevaluate this whole thing. Steroids are horrible, but the side effects are well known. I have RA and take a low dose of prednisone, among other meds, every day. I hate taking the prednisone, but it not only works wonders for my joints, but I know EXACTLY what to expect in terms of side effects. When we discussed the Atopica, the veterinarian made no mention whatsoever about potential increased risks of lymphoma.

I’m on the brink of losing all faith in the veterinary community.

[tarynls]

[QUOTE=catzndogz22;6897177]
Human drugs get shelved if the adverse reactions are out of line.[/QUOTE]

Keep in mind cyclosporine has been regularly used in human medicine, for many, many years. At high doses (MUCH higher mg/kg than is Rx in the veterinary community), it is an extremely effective immunosuppressant for those that have had organs transplanted.

Also, please keep in mind there are many, many people willing to post their bad experiences online - but you don’t hear nearly as much about the good experiences.

There is one article published in Journal of Small Animal Practice (2004), titled “Multicentric lymphoma in a dog after cyclosporine therapy”, and even in the abstract, the author states:

“Although a causative relationship between cyclosporine administration and the development of lymphoma cannot be proven in this case, it is possible that cyclosporine therapy may have contributed to lymphomagenesis… further work is required to substantiate and quantify the proposed increased risk.”

Note the article refers to a dog with multiple medical issues, not just skin allergies.

Is it possible? Sure. Probable? Not likely, especially at increasingly lower (tapered) doses, and a short (1 year) treatment course. As with anything, there is a risk & a benefit to consider. Unfortunately, steroids did not work with my dog, so I’m sticking with the cyclosporine.

[SBH]

My Sharpei has been on Atopica for several years with wonderful results. We were all miserable pre-Atopica days…I tried everything to no avail. We started with 100 mg every day for 30 days then reduced it to every other day. The only side effects I have found with my guy is occasional stomach upset. Every so often he’ll vomit up his dinner…but if I am careful with planning his mealtime vs medication time, he is fine.

[catzndogz22]

Follow up question

I gave Mojo his first dose tonight, 2 hours after his dinner. An hour and a half after that, he threw everything up, dinner and all. The prescribing vet didn’t really go into detail about how or when to give him the meds, but my understanding is that it should be given either an hour before or two hours after a meal.

For those of you who have used either Atopica or cyclosporine, what timing, relative to meals, worked best for you?

[tarynls]

With my dog (also a sensitive tummy dog), I give it 1 hour prior to meals, wrapped in cheese. Haven’t had an issue. What is your dog’s weight and what dose were you prescribed? (just curious).

Here’s some info from the Atopica website - “What to expect”. It does cover nausea/vomiting at the bottom of the page. http://us.atopica.com/treatment/what-To-Expect.htm

[catzndogz22]

He’s 75 pounds. We were prescribed 100 mg of Cyclosporine and 200 mg of Ketoconazole daily. The Ketoconazole allows us to reduce the dosage of the Cyclosporine.

I’ve been doing some more research and it looks like this combination can be hard on his liver. Considering a 4 day course of rimadyl caused acute liver failure (and death) in his sister, I want to be very attentive to liver function. I told the vet about my rimadyl experience and am actually a little pissed off now that he never mentioned anything about checking liver function while he’s on the cyclosporine.