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cyclosporine

Modality
small molecule
Mechanism
Cyclosporine is a calcineurin inhibitor that inhibits T cell activation.[A174049,A174088,A189411] Its binding to the receptor cyclophilin-1 inside cells produces a complex known as cyclosporine-cyclophilin. This complex subsequently inhibits calcineurin, which in turn stops the dephosphorylation as well as the activation of the nuclear factor of activated T cells (NF-AT) that normally cause inflammatory reactions. NF-AT is a transcription factor that promotes the production of cytokines such as IL-2, IL-4, interferon-gamma and TNF-alpha, all of which are involved in the inflammatory process. Specifically, the inhibition of IL-2, which is necessary for T cell activation or proliferation, is believed to be responsible for cyclosporine's immunosuppressive actions.[A174049,A189408] In addition to the above, the inhibition of NF-AT leads to lower levels of other factors associated with T helper cell function and thymocyte development.[A174049]
Targets
Calcineurin, Calcineurin subunit B type 2
Storage
Approved
psoriasis — FDA
In trial
rosacea, psoriasis, atopic dermatitis, alopecia areata
Sources
Last verified
2026-04-23
No curated MOA diagram yet. See lib/moa-data.ts for the shape; add an entry keyed by cyclosporine.

Monitoring & workup

Baseline workup

  • BP x2 separate visits
  • Serum creatinine x2
  • CBC, CMP, magnesium
  • Fasting lipid panel
  • Urinalysis

Ongoing monitoring

  • BP + Cr every 2 weeks for 3 months, then monthly
  • Magnesium + lipids every 3 months
  • Cap duration at ~12 months (renal/HTN risk)
  • Avoid live vaccines; watch for gingival hyperplasia, hirsutism