Ciclosporin + Hydrocortisone

The combination of ciclosporin (also spelled cyclosporine) and hydrocortisone is used primarily for treating dry eye disease, particularly in patients with Sjögren's syndrome. This combination leverages the anti-inflammatory properties of both medications to provide both immediate relief (from hydrocortisone) and long-term management (from ciclosporin). Cyclosporine is an immunosuppressive agent that inhibits T cell activation by binding to cyclophilin-1, forming a complex that inhibits calcineurin. This prevents the activation of nuclear factor of activated T cells (NF-AT), reducing the production of inflammatory cytokines like IL-2, IL-4, interferon-gamma, and TNF-alpha[4]. Hydrocortisone is a corticosteroid with powerful anti-inflammatory properties that tends to cause fewer side effects than other steroids[5]. When used together, these medications have shown efficacy in treating severe dry eye symptoms in patients with Sjögren's syndrome. The combination provides faster symptom relief than ciclosporin alone, as hydrocortisone offers immediate anti-inflammatory effects while waiting for ciclosporin's effects to develop (which typically takes 1-2 weeks)[5]. ## Drug Interactions When cyclosporine and hydrocortisone are used together, they may alter the blood levels and effects of both medications[6]. The metabolism of cyclosporine can be decreased when combined with hydrocortisone phosphate[4]. Coadministration may result in elevated plasma concentrations of one or both drugs[3]. ## Clinical Evidence A study published in the Journal of Ophthalmology found that combining hydrocortisone and ciclosporin A could help ease eye symptoms in people with Sjögren's syndrome. The combination group tended to perform better in terms of visual acuity after six months compared to ciclosporin A alone[5]. The researchers concluded that short-term hydrocortisone combined with long-term ciclosporin A therapy could provide fast improvement of clinical symptoms and may have positive long-term effects on optical image quality[5]. ## Administration and Usage Typically, hydrocortisone is used short-term at the beginning of treatment to provide immediate symptom relief, while ciclosporin A is used for long-term management. This approach helps avoid the potential side effects associated with prolonged steroid use while maintaining therapeutic efficacy[5].

Other names

Cyclosporine + Hydrocortisone