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Drugs that suppress the immune system, also called immunosuppressants, are usually used in combination with prednisone. These types of drugs are used by patients who have had organ or tissue transplants, such as a kidney transplant. They decrease the body's natural defense to foreign bodies, thereby preventing rejection of the transplanted organ by the body. This decrease in the body's own immune system activity makes immunosuppressants useful in the treatment of autoimmune diseases like pemphigus and pemphigoid.
When an immunosuppressant is used with prednisone, the dose of prednisone can often be reduced. For this reason, immunosuppressants are often called steroid-sparing drugs. Use of a steroid-sparing immunosuppressant, therefore, can help lower the undesirable side effects of prednisone. The most common immunosuppressants used to treat pemphigus are: - azathioprine (e.g. Imuran®)
- mycophenolate mofetil (MFM or CellCept®)
- cyclophosphamide (Cytoxan®)
Another sometimes effective immunosuppressant for treating PV is methotrexate. Cyclosporine (Sandimmune®) is also used to treat pemphigus, more frequently outside the United States. Side Effects and Precautions*While they can be very effective in the treatment of pemphigus and pemphigoid, immunosuppressants can have serious side effects. These include stomach upset, nausea, vomiting, abdominal pain, darkened urine, pale stools, and jaundice (yellowing of the skin or white portion of the eyes). Another serious side effect is reduced activity of bone marrow, but this can be monitored with regular blood tests. Occasionally, patients taking immunosuppressants will develop pancreatitis (inflammation of the pancreas) some months after starting these drugs. *Remember these drugs are often tolerated well for pemphigus/pemphigoid patients. Any side effect that has occurred for any patient is always included Care must be taken when using immunosuppressants. The following are some common-sense suggestions. - Avoid exposure to infections. Stay away from crowds and people known to have colds, the flu, or other infections.
- Do not take these drugs with other drugs, including over-the-counter medications, without first checking with your doctor.
- To minimize potential problems, wash your hands before touching eyes or the inside of your nose after handling these drugs.
- These drugs can cause fetal harm when administered to a pregnant woman. They should not be given during pregnancy without careful weighing of the risk versus benefit. Whenever possible, use of immunosuppressive drugs in pregnant patients should be avoided. They should not be used in nursing mothers.
- Regular blood tests should be performed routinely, as these drugs can lower your other blood counts.
Related WebsitesAzathioprine (Imuran®) Mycophenolate (MFM or CellCept) Methotrexate (Rheumatrex®, MTX®) Cytoxan Cyclosporine (Sandimmune®, Neoral®) |
