Cyclosporine-Induced Liver Function Abnormalities

Incidence and Pattern of Liver Function Abnormalities

• The British Association of Dermatologists guidelines note that cyclosporine therapy often induces small increases in serum bilirubin as part of its expected biochemical effects, which only occasionally cause clinical concern, in patients treated with cyclosporine 1

Clinical Significance and Monitoring

• The American Academy of Dermatology and British Association of Dermatologists recommend baseline liver function tests before initiating cyclosporine, followed by monthly monitoring during treatment, for patients on cyclosporine therapy 1, 2
• Monitoring should include assessment of alkaline phosphatase, bilirubin, and transaminases, with particular attention to the cholestatic pattern of injury, in patients on cyclosporine therapy 1, 2

Drug Interactions and Metabolism

• Drug interactions through the cytochrome P450 3A4 system can alter cyclosporine metabolism and potentially affect liver enzyme patterns, requiring careful review of concomitant medications, in patients on cyclosporine therapy 1, 3