Cyclosporine is the active ingredient of Atopica(®). It is an immunosuppressant which means it suppresses the body’s natural immune system responses, making it an option in the treatment of immune-mediated disease and preventing the rejection of surgical grafts and transplantations. The medicine is mainly used to treat and prevent itching, and preferable to corticosteroids in the long term because of the negative effects associated with the prolonged use corticosteroids.

Medicines covered: This article provides information and dosages for Atopica, Neoral(®), Optimmune(®) and Sandimmune(®).

Recommended Dosages

Never give your dog cyclosporine without veterinary approval, and be aware that not all cyclosporine medicines are dosed equally. Administer these medicines at least one hour before or two hours after a meal.


Atopica may be given to dogs weighing over 1.8 kg (4 lbs). The typical target dose is between 1.5 – 3 mg/lb for treating atopic dermatitis. These doses should be administered once daily for 30 days after which the dose should be tapered down to the lowest effective amount.

Dog’s weight (lbs)

Dosage (for atopic dermatitis)

4 – 6.51 x 10 mg capsule
6.6 – 92 x 10 mg capsules
9.1 – 161 x 25 mg capsule
16.1 – 331 x 50 mg capsule
33.1 – 641 x 100 mg capsule
64.1 – 791 x 100 mg capsule + 1 x 50 mg capsule
79.1 – 1212 x 100 mg capsules

Once tapered, the medicine may only need to be given every other day or twice per week. Atopica (or Neoral) can also treat the following conditions at the indicated dosage:

To treat…

Atopica/Neoral dosage

Inflammatory Bowel Disease (IBD)0.91 – 2.27 mg/lb twice daily
Pemphigus Vulgaris2.27 – 4.5 mg/lb Atopica + 2.27 mg/lb ketoconazole administered once daily


As stated, the dosage of Sandimmune is NOT equivalent to that of Atopica or Neoral. Do not use these medicines interchangeably. When used as a general immunosuppressant, Sandimmune is typically dosed at 2.28 – 5.68 mg/lb every 12 hours. It can also be used for the following conditions:

To treat…


Anal fistulas2.28 – 3.4 mg/lb administered every 12 hours (taper down when lesions heal)
Glomerular nephritis6.8 mg/lb administered every 24 hours
Hemolytic anemia (immune-mediated)4.5 mg/lb administered every 12 to 24 hours


Optimmune is a topical opthalmic medicine which can be used to treat Dry Eye Syndrome (DES). To correctly use Optimmune you should place a quarter inch strip of ointment onto the lower eyelid.

Safety Profile

Adverse effects are usually limited to gastric effects, and it is a perferable choice to corticosteroids for treating certain chronic itching conditions. It may not be safe for dogs with liver or kidney disease, or those with a history of malignant neoplasia. It also interacts with a very large number of medicines and substances.

The FDA has approved this drug for veterinary use under application numbers 141-218 and 141-052. You can see the documentation submitted to the FDA by Novartis at

Pregnancy/Nursing: We advise that owners should not administer this medicine to pregnant or nursing dogs.

Guidelines For Use

When using any cyclosporine medicine we suggest following these guidelines:

  • Do not use unless directed to do so by a vet
  • Stick to using the form of cyclosporine recommended by your vet *
  • Administer at least one hour before or two hours following a meal
  • Notify the vet of your dog’s medical conditions (if any are present)
  • Notify the vet of any other medicine or supplements you give your dog

* For example, if the vet prescribes Atopica, do not substitute for Sandimmune due to differing dosages.

It’s important that you don’t give any new medicines to your dog while they are taking cyclosporine until your vet has told you it’s okay to do so. This is to avoid unwanted drug interactions.


This drug is most often used for:

  • Treating atopic dermatitis
  • Preventing the rejection of grafts/transplants


Side Effects

The most common adverse effects are gastric related (vomiting, diarrhea). But there have also been reports of gingival enlargement, excessive hair growth, excessive hair shedding and papillomatosis. Overdoses may result in kidney or liver damage.


Dr. W. Rosenkrantz
Plumb’s Veterinary Drug Handbook (sixth edition)