Immunosuppressants

Immune-mediated diseases occur when the immune system, which is designed to kill germs, inappropriately attacks the body’s own cells or tissues. Immunosuppressive therapy involves using a combination of medications to control and suppress this inappropriate immune response.

Some of the most common immunosuppressive medications are:

• Prednisone (or prednisolone) is a mainstay of treatment for most immune-mediated diseases. Prednisone works by blocking a wide range of immune responses. Prednisone is associated with a wide variety of side effects, which can be found on the summary medication table. The most common side effects are more annoying than dangerous.
• Azathioprine: This drug is given once a day to start, but dosing can often be tapered to every other day or even a few times a week. It takes weeks to start working and can reduce bone marrow cell production.
• Cyclosporine: This drug acts rapidly and doesn’t suppress cell production in the marrow. We will often measure the concentration of the drug in the blood to be sure the dose is correct.
• Leflunomide: This drug starts to work in a few weeks and has relatively few side effects. It is usually given once daily at first.
• Methotrexate: Used in humans for rheumatoid arthritis, this drug is also used for IMPA in dogs. It is usually given once or twice a week, and it takes a few weeks to show any benefits.
• Mycophenolate: This drug is given once or twice daily to start, and it begins to work in days.