Down with Dermatitis: Atopica Allergy Medication for Cats and Dogs

When to Use Atopica for Dogs

Atopica is an option when your dog has atopic dermatitis or any allergic dermatitis that could benefit from immune system suppression. Cyclosporine works by affecting the immune cells involved in the allergic reaction. In other words, it inhibits the immune response, thus resulting in decreased inflammation and allergy symptoms. 

According to Dr. Rhiannon Koehler, “Atopic dermatitis is one of the most common medical conditions we see in dogs. It can also be one of the most frustrating for you, your pet, and your veterinarian alike. Atopica can be a good option for your dog if non-prescription items aren’t providing adequate relief, but we do recommend you work with your veterinarian to monitor for side effects. Although most dogs do well on this medication, some side effects can be severe enough that the medication needs to be discontinued”.

Benefits and Uses of Atopica for Dogs

The official use of Atopica for dogs is for managing skin allergies or, more specifically, atopic dermatitis. Atopic dermatitis typically occurs in dogs who have a dysfunctional skin barrier that allows penetration by environmental allergens. 

The immune system misidentifies the allergen as a threat and overreacts to its presence, leading to an allergic reaction and its telltale symptoms: itching, licking, scratching, skin infections, chewing, gnawing, sleepless nights, hair loss, and a terrible odor. 

Cyclosporine suppresses the immune system and reduces this overreaction, thus preventing the signs of atopic dermatitis in dogs. 

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What Are the Side Effects of Atopica on Dogs?

The most common side effects of Atopica in dogs are vomiting, diarrhea, and loss of appetite. Gastrointestinal problems are not the only adverse effects. Though severe side effects are rare, they are possible. 

Below is a more detailed list of the Atopica side effects:

• Gingival hyperplasia (excessive growth of the gums)
• Depression or lethargy 
• Altered glucose metabolism
• Excessive hair growth (hypertrichosis) and shedding
• Papillomas on the skin
• Urinary tract infections
• Skin infections
• Liver injury (rare)
• Blood clots (rare)
• Kidney injury (not reported for current formulations)
• Tremors (high doses)
• Opportunistic infections, such as fungal infections

Because of the long list of adverse reactions, Atopica must be used with caution in:

• Dogs with diabetes mellitus
• Dogs with renal insufficiency 
• Dogs with compromised immune systems

Atopica must not be used in: 

• Puppies younger than six months
• Dogs weighing less than 4 lbs
• Dogs with a history of neoplasia
• Pregnant and lactating dogs
• Dogs on meds with drug interactions  

Cyclosporine may affect how effective your pet’s vaccinations are. Studies currently show that killed vaccinations, such as the rabies vaccine, are still effective when given to dogs on cyclosporine. 

The effect of Atopica on the immune response to live vaccines is still being studied, so some veterinarians may recommend against live vaccines when your pet is taking this medication. Work with your veterinarian to discuss an appropriate vaccination schedule for your pet. 

Also, Atopica may increase your dog’s infection susceptibility due to immunosuppression. You need to call the veterinarian if your dog develops a fever, loss of appetite, tiredness, coughing, sneezing, runny nose, pustules on the skin, or blood in the urine after starting Atopica.  

Lastly, as a systemic immunosuppressant, Atopica may also increase the risk of developing neoplasia. This is because dogs need a properly working immune system to protect themselves from malignant formations. Although there is evidence that this occurs in humans on cyclosporine, evidence in veterinary medicine that dogs experience this side effect is currently lacking.

Atopica Dosage for Dogs

The Atopica dosage for dogs is 2.2 mg/lbs (5 mg/kg) as a single daily dose for 30 days. After that, the frequency of use can be decreased to every other day or twice per week. The goal is to achieve the minimum frequency that yields therapeutic effects. 

Atopica tablets come in several strengths – 10 mg, 25 mg, 50 mg, and 100 mg. However, they cannot be crushed or opened, which means finding your dog’s right dosage may require multiple capsules, sometimes of different strengths. Here is a short explanation of how to combine the Atopica strengths:

• 4-6.5 lbs: 10 mg capsule
• 6.6-9 lbs: 2 x 10 mg capsule
• 9.1-16 lbs: 25 mg capsule 
• 16.1-33 lbs: 50 mg capsule 
• 33.1-64 lbs: 100 mg capsule
• 64.1-79 lbs: 100 mg + 50 mg capsule 
• 79.1-121 lbs: 2 x 100 mg capsule.

Your veterinarian’s recommendation may differ from this chart. We recommend following your veterinarian’s dosage recommendations. 

Atopica medication is also available in the form of an oral solution (100mg/ml). However, the oral suspension form is intended for use in cats. 

Atopica is best given on an empty stomach – one hour before or at least two hours after meals. Some dogs may vomit when they first start taking Atopica, in which case your veterinarian may recommend giving the medication with food, at least initially. 

If you accidentally forget a dose, either give it as soon as you remember or skip it completely. Never double-dose your dog to compensate for the missed dosing. 

Atopica for Dogs: Additional Usage Guidelines

Before the veterinarian prescribes Atopica for your dog, they will carefully evaluate the situation and consider both the benefits and possible adverse reactions. 

The vet will pay attention to your dog’s medical history and current medication treatments because certain meds may increase or decrease the plasma levels of cyclosporine. Here is a list of several medications with known cyclosporine drug interactions:  

• Some antibiotics (SMZ-TMP, gentamicin, erythromycin)
• Meds affecting the P-450 enzyme system (e.g., ketoconazole)
• Antacids (cimetidine, ranitidine) and  antiemetics (metoclopramide)
• Heart medications like digoxin
• Corticosteroids like prednisone 
• NSAIDs like carprofen, and piroxicam
• Allopurinol

This list is not all-inclusive, and there are quite a few other medications that may have interactions with cyclosporine. Always discuss all medications your pet takes with your veterinarian prior to starting a new medication.

Once you have the Atopica, there are some special precautions for handling and storage. The cyclosporine capsules must not be broken, crushed, or opened. Also, you must always wear gloves and then wash your hands after handling. 

The medication should be stored in its original unit-dose container at room temperature and out of reach of children. Since Atopica is not for human use, seek medical advice and provide the label or package insert to your physician in case of accidental ingestion. 

Atopica Alternatives for Dogs

Atopica is not the only prescription medication available for dogs. Other options to discuss with your veterinarian could include antihistamines like cetirizine, Apoquel tablets, Cytopoint injections, and steroids. 

You could also consider referral to a dermatologist for allergy testing and immunotherapy, often called “allergy shots” in people. Regardless of what you choose, it is essential to get any secondary skin infections under control first to maximize your success.

If you are interested in natural and safe alternatives, you could consider items such CBD oil and/or salmon oil. The list of side effects and adverse reactions is scary enough to put some pet owners off the idea of using Atopica. 

CBD Oil for Dogs. Extracted from hemp, cannabidiol (CBD) oil is an option for dogs with atopic dermatitis. Instead of suppressing, cannabinoids work by modulating the immune system. Our recommendation is Honest Paws CBD Oil. It is full-spectrum and made from organically grown hemp in the U.S.

Salmon Oil for Dogs. Fish oil has strong anti-inflammatory properties and is rich in skin health-boosting omega fatty acids. It helps relieve dry and itchy skin while providing moisturization and soothing effects. We recommend using the Vets Preferred Wild Alaskan Oil. This product is vet-recommended and made of Alaskan wild-caught salmon. Some veterinarians will recommend fish oil as an adjunctive therapy used in combination with a prescription medication

Finally, whether Atopica is the right choice for your dog is something you need to discuss with a licensed veterinarian. Remember, this article is intended for educational purposes and is not intended to replace professional advice.