Cyclosporine: indications and use in gastrointestinal diseases

Cyclosporine is the most important drug used in transplant medicine, and it has revolutionized the field of organ transplantation. It suppresses cytotoxic T-cell activity without producing myelosuppression. Recently, its use has been expanded to include an increasing number of immunologically mediated disorders. Many of these diseases involve the liver and the gastrointestinal tract, which is therefore of interest to practicing gastroenterologists. However, cyclosporine is associated with a number of adverse effects. A knowledge of these side effects and their management is essential for any physician who intends to use this drug. Current gastrointestinal indications and a practical approach to cyclosporine use in gastroenterology are discussed.