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Tries Creative Dosage of Cyclosporine
Ed! I just wanted to touch
base with you regarding my cyclosporine dosage.
After a recent flare up, I asked my derm if we could please
increase the dosage just a bit. As
I mentioned, I had decreased my dosage to 100 mg daily due to
hypertension. When I first
decreased the dosage, I had a relapse of new lesions, but after a couple
of months, they had subsided somewhat, although not nearly as clear as
when I was on the maximum dosage. My
derm has agreed to let me try 200 mg Monday, Wednesday and Friday, and
keep the off days at 100 mg. I
have definitely noticed a difference, although I am almost afraid to tell
my derm that my blood pressure has been running about 160/100, give or
take. I know that this can
eventually cause me many internal problems, but I seem to need the higher
dosage to maintain clearer skin. Catch 22, ya know? My
derm wanted me to take Norvasc for my blood pressure because she felt that
it helped blood flow through the kidneys, but my cardiologist said that it
is in the same family as the Verapamil I take for my irregular heartbeat,
so he has me on Accupril.
the increase in dosage of cyclosporine, I don't need to apply as many
topicals as often, which is wonderful, because you know how grueling that
can be. My RX plan is 15% of
the retail cost of a medication or a maximum out of pocket expense of $20
per RX. I typically spend on
average of about $170 a month on RXs, which beats the retail cost of
$2,000 (retail total of last months' RXs).
The retail cost of Dovonex alone costs $350.99 for 200 grams and I
get that filled every 2 weeks, and that's only using it 3 times a week.
The retail cost of the cyclosporine is $181.99 for 30 - 100 mg.
capsules. By the way, I use a
generic cyclosporine, which is equivalent to Neoral.
I haven't noticed an increase in weight though.
I am on average about 125, and I blame the recent holiday bingeing
on a gain of about 10 pounds, which I am trying to currently lose.
Response: Thanks for
the update, Michelle. The
more you write about your derm, the more I like this doc!
No one has ever mentioned to me, nor did it ever occur to me, to
consider high/low dosing for cyclosporine when I was trying to find that
“ideal dose” to maintain clearance.
Why? I wonder....
the blood pressure continues to be a problem you might ask your derm about
methotrexate. (I’m probably
going back to it in the next month or so.)
It’s not necessarily a better drug for P, but it doesn’t
elevate blood pressure as predictably as cyclosporine.
You and I both tend to be hypertensive anyway.
You mention you have a cardiologist:
I don’t suppose s/he was thoroughly delighted at the prospects of
you using cyclosporine in the first place.
you imagine trying to manage your P without your prescription insurance?
Many people do and I suppose many of the alternative and dietary
therapies written about here were discovered by people looking for lower
thought the cost of the strong topical corticosteroids and
vitamin-derivative concoctions was outrageous until I started systemic
therapies (first MTX and now cyclosporine).
Now the cost of these — as alarming as they are — pale in
comparison to the new monoclonal antibody therapies like Remicade
infusions (see Remicade Success Story
in this month's mail). Because we flakers are a relatively minor
demographic in the pharmacological scheme of things, it’s doubtful
we’ll see costs ease off. At
least, that’s my pessimistic outlook.
As bad as it is for some to have good therapies priced beyond their
means, my anger is going to peak when a cure is discovered and only the
teen-tiniest percentage of us will be able to afford it.
Stay in touch, Michelle. -Ed