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  • Cyclosporine still available in UK? / Lymecycline

    Hi All

    Just wondering if anyone can help.. At my last Moorfields appointment I was told there is a manufacturing issue with Cyclosporine 0.06% eye drops (which I believe is the UK Restasis equivalent). I was given Optimmune ointment instead which I haven't found helpful, I think because as well as watery dry eyes I’m told I have posterior lid margin disease and blocked meibomian glands in all four lids. Applying a greasy ointment to the lids seemed to counteract all my daily unblocking attempts right from the start, with the result that my eyes felt drier than when I wasn’t using it and my vision was blurred at times (on the plus side it was a really nice moisturiser for the skin around my eyes and I may even have lost a few small crows’ feet). Does anyone know, is it still worth trying Cyclosporine if Optimmune has this effect and why has it stopped being made? Also, I've heard it makes the eyes very red, does this stop after a while or will the redness last for as long as you are using it? All the Doctors I’ve spoken to about it have stressed that it does sting quite a lot so although I need more tears in order to increase my functionality, I’m not sure I should hope that this will be the big cure (if I can get it). If anyone has thoughts or comments on this it would be very appreciated.

    While I am on-line, I’m happy to share my recent experience of Lymecycline (which had been my other last hope) for anyone curious about using this, although I imagine the effects will differ a lot depending on the user. I was prescribed one Tetralysal 300mg capsule per day (equivalent to 408mg Lymecycline) and had noticeable side effects from early on. After a day or two it felt like I had a dry cracker wedged down my throat, then a few more days in, I realised that overnight I seemed to look 6 months pregnant. I do seem prone to inflammation in general and it’s fair to say I felt uncomfortable while taking this drug! Other unexpected effects were that the surfaces of my teeth felt peculiar, sort of rough and dry and I had also woken up a couple of times in the night with a start, almost in a panic, which hasn’t happened before. I’ve never had such a noticeable reaction to a medicine and I did check back to the list of side effects on the package leaflet and there are a lot, and very varied. Fortunately within a short time of stopping usage everything was back to normal. My local Eye Doctor was wary about prescribing it at all until all other avenues had been explored, although my GP thought it worth a try and the Moorfields Doctor I saw recently felt it was a shame about the side effects as evidently it can be really helpful in 'melting' oil blockages and keeping them flowing, in cases like mine. So it might be worth a try for anyone with badly blocked oil glands but I would say you might have to try it before pinning your hopes on it.

    Best wishes to all and thanks in anticipation of your help.

  • #2
    Hi. I last had Cyclosporine 0.06% prescribed in May. It's REALLY expensive compared to Optimmune buy my Ophth pushed for it. Not sure if there is a genuine manufacturing issue or just cost cutting. It's still on Moorfields formulary http://www.moorfields.nhs.uk/sites/d...uly%202014.pdf If you were to buy it with a private prescription it's over £200 a bottle. One bottle lasts 7 days.

    I've used Lymecycline in the past but didn't help me (nor do any tetracyclines). A couple of Moorfield's private Ophthalmologists prefer it to Doxy. I'm sorry you had a bad reaction to it.

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    • #3
      I tried Cyclosprine a few years ago and had an adverse reaction to it - so severe that the details were communicated to some kind of regulatory agency once Moorfields had been informed. My consultant had prescribed it (privately) so I had to shop around the pharmacies to see who could get it and how much they would charge. A small independent chemist was the cheapest; a small bottle (10 ml at most) cost around £130. It was meant to be one month supply but I had to discard it after a few days.

      (I was once prescribed Optimmune some years ago too - and that was terrible!)

      Sorry, unsure if my experience has helped you with your question!

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      • #4
        Hey, at my appointment yesterday with a really knowledgeable and kind dry eye ophthalmologist I was told that the plant that manufactures restasis in the uk has lost it's license and is trying to get it back, I think she said that moorfields are importing it from America which is costing a lot more money, hopefully they will get the license sorted soon, it seems crazy that such an important medicine is only manufactured by one plant in uk,

        Cath x
        27, pinguecula, dry eye, Wirral, UK

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        • #5
          Hi thank you Little Mermaid (who pm'd me), Lizlou, Irish Eyes and Cathy. I had a great Doctor at my appointment yesterday, who listened (which can be a rarity in itself) and made some phone calls. What I was told seems to agree with what everyone's said. There is a licencing issue at the moment and the only availability in the UK is via import. Amazingly, after a lot of enquiries and a trip to a second hospital, I managed to leave with a 2 month supply of Restasis although the pharmacy was at great pains to assure me they could not guarantee continuity of supply or even any further supply. What I have got is 2 trays of 30 vials, of 0.05% preservative free Restasis. I'm now wondering whether I've got gold dust or something I'm going to have a further bad reaction to (eek to your comment Irish Eyes!) Hopefully it will be ok because of not having preservatives? I will start using this over the weekend and will post again once I know how it's going and thanks again to everyone. x x

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          • #6
            Royal College of Ophthalmologists 'Ophthalmic Specials Guidance Updated' 15.08.14 http://www.rcophth.ac.uk/news.asp?it...tionTitle=News Details cyclosporine (ciclosporin). You've got unpreserved gold dust, Tfour!

            Update on Moorfields Pharmaceuticals situation 24.06.14 http://www.rcophth.ac.uk/news.asp?it...tionTitle=News 'identifying alternative supplies from other UK manufacturers or from overseas. Moorfields Pharmaceuticals is also sharing formulations and offering specialist advice and technical support to other manufacturers where needed to speed up the supply of products'
            Last edited by littlemermaid; 25-Aug-2014, 10:22.
            Paediatric ocular rosacea ~ primum non nocere

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            • #7
              I had restasis prescribed and dispensed to me at a hospital in Glasgow. Seems like it's more available than they'd have us know!

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              • #8
                Excuse my ignorance but do cyclosporine and restasis have exactly the same ingredients?

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                • #9
                  Originally posted by lizzyk View Post
                  Excuse my ignorance but do cyclosporine and restasis have exactly the same ingredients?
                  I'm confused too. I just had an appointment this week with an opthalmologist. I asked about restasis (as nothing has helped so far, including Doxy) and he told me that wasn't available but he would prescribe me the generic version. I've been prescribed ciclosporin (optimmune) 0.2%. The packet says it is for animal use but humans can use it if prescribed by their doctor.

                  I assumed it was the same as restasis - as the opthalmologist told me it was the generic version. Reading these posts, I don't think that's the case?

                  I'm not sure whether to try it now especially after reading the posts here. I have tried two other ointments before and these didn't help and made my eyes worse during the day.

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