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Tacrolimus is one of a group of relatively new drugs
called calcineuron inhibitors. These drugs are anti-inflammatory, and
immunosuppressive or immunomodulatory. The mechanism of action is through
the inhibition of calcium dependant pathways that effect the enzymatic
action of calcineuron. This in turn blocks the proliferation of T lymphocytes
and cytotoxic cells. When one reviews the human literature, calcineuron
inhibitors are widely investigated for use in atopic dermatitis and in
organ transplant recipients. At the present time, veterinary use of tacrolimus
is primarily for ketratoconjunctivitis sicca in dogs and cats and immune-mediated
dermatologic diseases.
Keratoconjunctivitis sicca due to decreased tear production
is primarily an immune-mediated disease of the lacrimal glands. It is
seen more commonly in dogs than in cats. Cyclosporine and tacrolimus are
the two drugs most commonly used to stimulate tear production. Cyclosporine
has been the standard drug for years although topical ophthalmic tacrolimus
is thought to be considerably more effective and as a result may be useful
in animals that are refractory to cyclosporine. Animals with immune-mediated
KCS will need to be on treatment for the rest of their life.
Topical tacrolimus maybe also be useful in localized treatment of atopic
dermatitis, pemphigus, lupus erythematosus complex, miliary dermatitis,
eosinophilic granuloma complex.
• Tacrolimus is very well tolerated in the ophthalmic treatment of KCS
• Tacrolimus is generally well tolerated for the
localized topical treatment of dermatologic problems. GI symptoms may
be encountered from ingestion of the topical ointment (licking).
• Only topical use of tacrolimus is currently recommended.
There is not sufficient information regarding systemic use.
• No information regarding drug interactions was found.
• No information regarding overdosage was found
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
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