Increased amt of cyclosporine-side effects?

[willwork4tears]

Unfortunately here in the UK only 2% is available. Also it's an unlicensed medicine and doesn't come with an information sheet - so not really sure what's in it - though I do know it's PF.

Oooh...that sucks! You can't find out what else is in it? Can you find out how they make it? I would at least try to figure out how much alcohol is in there. Since you can't get any other dose, I would try to stick out the 2% and see how it goes.

GOOD LUCK!

[irish eyes]

Jlg

Out of curisosity, was it easy enough to obtain your Cyclosporine drops? I wonder if it's the Moorfields Hospital brand.

The Moorfields product is stronger than Restasis, and is not as well tolerated (it can make the eyes feel sore).

Taken from:
http://www.goodhope.org.uk/departmen...0dry%20eye.htm

Last year, I looked into this on behalf of my GP but the pharmacists were really evasive when I enquired.

[jlg_uk]

Jlg

Out of curisosity, was it easy enough to obtain your Cyclosporine drops? I wonder if it's the Moorfields Hospital brand.

The Moorfields product is stronger than Restasis, and is not as well tolerated (it can make the eyes feel sore).

Taken from:
http://www.goodhope.org.uk/departmen...0dry%20eye.htm

Last year, I looked into this on behalf of my GP but the pharmacists were really evasive when I enquired.

Yes - it is the Moorfields brand. It was prescribed by my hospital Ophth, and I was surprised to find the on site pharmacy had some.

I'd read it wasn't well tolerated (and is 40 times stronger), and it was something a previous Ophth had said to me when I asked about the product. I will try to find out what is in it though.

[jlg_uk]

Actually turns out that the label indicates both alcohol and maize oil. Quantities not mentioned, but I guess alcohol isn't very eye friendly.

Hopefully more a case of temporary irritation rather than damage I should be worried about.

[indrep]

Remember, cyclosporin is acting only as an antiinflammatory for the lacrimal ducts. Increasing the concentration to a 100% will not make your eyes feel better if your lacrimal glands aren't producing tears. And I mean "steady state" tears.

The goal is to capture and maintain as high a volume of steady state tears as possible on the ocular surface. There has been significant research that shows after as little as 36 months of inflammation the lacrimal glands become compromised in their ability to manufacture tears.

[jlg_uk]

Remember, cyclosporin is acting only as an antiinflammatory for the lacrimal ducts. Increasing the concentration to a 100% will not make your eyes feel better if your lacrimal glands aren't producing tears. And I mean "steady state" tears.

The goal is to capture and maintain as high a volume of steady state tears as possible on the ocular surface. There has been significant research that shows after as little as 36 months of inflammation the lacrimal glands become compromised in their ability to manufacture tears.

I'm plugged as I do have decreased lacriminal output. Does this mean 2% cyclosporine is a waste of time for me?

[ringo]

Just like some of you guys here I am taking the 2% cyclosporin in corn oil. I have to say that at every stage of increasing the cyclosporine concentration up to 2 % it came with an initial period of eye irritation, redness, discomfort, and discharge from the eye. But if you persist the eye seems to adjust to it. Putting a drop of Akular or FML before you instill the cyclosporine also helps a lto to de-sensitize the eye.

I think that my persistence is really paying off-- the biggest difference I feel is more tears and reduction in corneal oedema (that is the type that due to the dryness adn inflammation makes your eye look considerably smaller and aged).

With dry eye nothing works fast. All medications require time to produce any noticeable results. That is especially true for cyclosporine. That is why in the initial phases of treatemtn doctors combine it with a mild steroid and/or NSAID drop, coz otherwise it might look as if the eye is actually deteriorating not improving, ususally during the first 2 months of treatment.

[Rebecca Petris]

Actually turns out that the label indicates both alcohol and maize oil. Quantities not mentioned, but I guess alcohol isn't very eye friendly.

What kind of alcohol does it list?

[ringo]

i think this is important to mention

Remember, cyclosporin is acting only as an antiinflammatory for the lacrimal ducts. Increasing the concentration to a 100% will not make your eyes feel better if your lacrimal glands aren't producing tears. And I mean "steady state" tears.

The goal is to capture and maintain as high a volume of steady state tears as possible on the ocular surface. There has been significant research that shows after as little as 36 months of inflammation the lacrimal glands become compromised in their ability to manufacture tears.

Cyclosporine is an antiinflammatory, as it seems to "disarm" effector T-lymphocytes involved in the inflammation. However, it is also the only topical lacrimal stimulant approved on the market. The mechanism by which cyclosporine stimulates the lacrimal glands to produce moer tears is not entirely clear to scientists, but it is a fact-- cyclosporine is both antiinflammatory and tear gland stimulating agent. Also, it has been shown that tear stimulation is relative to the concentration of the topical solution: a 0.05 % produces significantly less lacrimation than a 2% solution.

Cyclosporine can maintain a compromised tear gland functioning but if it is stopped in such a case, the condition will relapse and deteriorate, and the gland willl become completely dysfunctional over time. Then of course, cyclosporine will only be able to control inflammation. That is why in dry eye the goal is not only to capture the tears alrady on the surface of the eye, but to continuously stimulate the glands while controlling inflammation, which will prevent further deteriorationn (even atrophy) of the glands.

Interestingly, normal amount of tears can be produced even if there is only 5-10 percent remaining viable lacrimal tissue in the gland. The actula amount of viable matter in the lacrimal gland usually does not correspond to the amount of tears produced. That is because it is not the gland which is compromised; but due to substances involved in inflammation the function of the receptors of the nerve signalling to the gland are compromised. That is why taking pilocarpine increases tear production, as it is a nerve signalling substance.

[jenny2008]

Ringo-thank you for posting your great results. I am going to go ahead and try it.. ihave nothing to lose..calling my doc tomorrow..thanks for letting us know to use steriods beforehand..

[odydnas]

Wow, thanks for the great explanation!!

Some docs use Restasis to control inflammation for MGD (altho I dont know if it actually works).

With that said, does anyone know of whether or not Restasis, as well as an increased dose of Restasis, do anything for the meibomian glands?

[jlg_uk]

What kind of alcohol does it list?

It doesn't - just alcohol. It wasn't supplied with the best information in the world sadly

[Aaron77]

C That is why taking pilocarpine increases tear production, as it is a nerve signalling substance.

why are more docs not prescribing pilocarpine?

[nycdryeyegirl]

Hi Ringo!

"Interestingly, normal amount of tears can be produced even if there is only 5-10 percent remaining viable lacrimal tissue in the gland. The actula amount of viable matter in the lacrimal gland usually does not correspond to the amount of tears produced. That is because it is not the gland which is compromised; but due to substances involved in inflammation the function of the receptors of the nerve signalling to the gland are compromised. That is why taking pilocarpine increases tear production, as it is a nerve signalling substance"]

Does the above information you presented come from a specific periodical or journal? Thanks.

Pam

[willwork4tears]

Most people don't see an improvement in tear production when taking pilocarpine or Evoxac (the 2 drugs that stimulate saliva production). Mechanistically/theoretically increased tear production is possible. The doctors always tell you it "might" increase tear production, but I've tried both and neither did anything for my eyes. They are great for dry mouth and work very well to increase saliva production.

why are more docs not prescribing pilocarpine?