Atopica is a common drug used in the canine world. But it comes with loads of side effects and a price tag that has many owners wondering if it's worth it. Here, we look at the uses of Atopica in dogs, the downsides, and natural alternatives to help your dog find relief from atopic dermatitis.
What Is Atopica?
Atopica is a drug approved for the treatment of atopic dermatitis in dogs. It's also used as an anti-rejection drug in humans, among other uses.
The active ingredient in Atopica is cyclosporine, a mycotoxin produced by fungus. Like other mycotoxins, this one is produced by fungi to kill bacteria and competing fungi. It accomplishes this by inhibiting certain cellular functions. In humans and dogs, cyclosporine inhibits T-cell function, which greatly reduces cytokine production.
Atopica is the only form of cyclosporine that is FDA-approved for use in dogs and only for the treatment of atopic dermatitis. The drug is quite expensive, especially at higher doses. Generic forms of cyclosporine have been approved for human use but tests in dogs are limited. Initial research indicates there may be a greater variation of effectiveness when using the generic in dogs compared to Atopica.
What Is It Used for In Dogs?
In dogs, Atopica is used predominantly to treat atopic dermatitis. This type of pruritus (itchy skin) is caused by an overactive outer layer of skin and is associated with IgE antibodies to environmental allergens. When allergens contact the skin, the immune system reacts by producing cytokines, which cause inflammation, redness, and itchiness. These symptoms can be seasonal or year-long, depending on the offending allergen.
Ten to 15% of dogs suffer from atopic dermatitis. Clinical trials have shown that Atopica is highly effective at suppressing the inflammatory response of the immune system in the skin. Most dogs who are put on Atopica see a noticeable reduction in skin inflammation and scratching.
However, because Atopica is a systemic immune suppressor, there are risks to using this product, as well as many side effects. More on that in a moment.
How Is It Administered?
In dogs, the most common form of Atopica comes in capsule form. Giving the capsules with food can help reduce nausea, a common side effect. Many vets also recommend storing the medication in the freezer to slow the release, which can reduce gastrointestinal upset.
Importantly, Atopica should not be directly handled. Gloves are recommended for administration, and hands should be washed promptly after handling. When cyclosporine-containing medications are administered to humans in hospitals, a number of precautions are taken, including the use of gloves and protective gear to reduce the likelihood of skin contact.
Side Effects of Atopica in Dogs
Atopica carries a relatively high risk of side effects compared to many common medications. These include a range of common side effects as well as some less common, more severe effects.
Common Side Effects
In trials, an impressively high 31% of dogs given Atopica experienced vomiting. Another 20% had diarrhea. In some cases, these gastrointestinal symptoms resolved on their own, but in others, the dose or administration technique needed to be modified to avoid these side effects. Some dogs never overcame this reaction and had to be taken off the drug.
Other common side effects include ear infections, urinary tract infections, lack of appetite, lethargy, gum tissue overgrowth, and swollen lymph nodes.
Atopica also causes many internal side effects, particularly with the concentrations of different compounds in the blood. The most common side effects here are changes in creatine, cholesterol, blood urea nitrogen, and calcium levels.
Ironically, many dogs suffer dermatological issues as a side effect of Atopica. These may be worse than the initial atopic dermatitis symptoms. Dermal side effects include excessive hair growth in concentrated areas, excess shedding, warts, excessively thick skin on the footpads, psoriasiform-lichenoid-like dermatitis, precancerous lesions, and lymphoplasmacytic dermatitis.
Because Atopica is an immunosuppressant, dogs on this drug are at an increased risk of infection.
The most common infections are respiratory and urinary tract infections. More severe infections have also been reported, including kidney infections, uterine infections, infections of the pericardium around the heart, septic arthritis, toxoplasmosis, parasite infections, infected hair follicles, and bacterial skin infections.
Severe Side Effects
Atopica also carries a potential for rare but severe side effects. These include:
- Malignancies – Lymphoma and other cancers.
- Hepatotoxicity – Liver damage
- Defective hepatic protein synthesis – A common symptom of liver damage.
- Insulin defects – Including insulin inhibition and resistance, which can result in diabetes mellitus.
- Lameness
- Nephropathy – Kidney damage and disease.
- Angioedema – Swelling of the paws, mouth, or other parts of the body.
- Tremors
Not surprisingly, many of these side effects are considered common symptoms of mycotoxin toxicity.
It’s also important to consider that no study of cyclosporine or Atopica use in dogs has followed test subjects longer than 12 months. There are likely risks associated with the long-term use of this drug that have not been studied.
This is problematic, considering that many dogs who have atopic dermatitis are placed on lifelong regimens of Atopica. Because of this, owners should be aware and vigilant about the potential for side effects not listed here, especially if your dog has been on the drug for more than a year.
In humans, long-term cyclosporine use is associated with seizures, bloody vomit, diarrhea, and urine, hearing loss, vision problems, and tingling and pain in the torso and extremities.
It’s also worth mentioning that many dog owners see a decrease in the effectiveness of Atopica over time. This effect may very well be caused by the secondary dermatitis symptoms the drug induces.
Natural Alternatives to Atopica
Whether you use a conventional approach to atopic dermatitis, such as Atopica, Apoquel, or Piriton, or choose a more holistic route, it's unlikely any one thing is going to provide complete relief. This is because you can’t only treat the symptoms, you must also address the underlying cause.
A multi-angle approach is especially important when looking into natural alternatives to treat itchy skin. You’ll need options to relieve the swelling and itchiness your pet is experiencing while you treat the underlying cause and support healing throughout the body. Luckily, there are many effective, all-natural solutions for atopic dermatitis that you can try.
Care for the Skin
The first step to treating dermatitis should always be to address your dog's discomfort. After all, the more they scratch, the more inflamed the skin becomes and the itchier they feel. There are a number of approaches you can try to reduce inflammation and soothe itchy skin.
Frequent Bathing with Moisturizing Shampoo
Bathing your dog frequently, even daily, is one of the best things you can do to help them find relief. The key here is to use an all-natural shampoo that helps moisturize and rebuild the skin rather than a product that will dry the skin out. Be sure to avoid harsh shampoos with synthetic ingredients, as these can strip the natural oils from your dog’s skin and cause more irritation. Look for a gentle, natural shampoo that contains aloe vera, oatmeal, and/or ceramides.
If your dog’s itching gets worse, reduce the frequency of bathing or try a different shampoo. You can also rub coconut oil on their skin after you bathe them to help protect the skin from drying out.
Not only does daily bathing allow you to apply helpful topical ingredients that reduce irritation and support a healthy skin barrier, but it also removes the allergens that are causing the reaction in the first place.
Apply Soothing Topicals
MCT oil, CBD oil, calendula, green tea, and chamomile are all excellent topical options to help soothe your dog’s skin. Tea made from green tea leaves, chamomile flowers, and calendula flowers is great for soaking in inflamed areas. It can also be used as a final rinse after your dog’s daily bath. Afterward, I recommend applying a mix of MCT and CBD oil directly to the skin.
Start with the Gut
The above will help control the symptoms of atopic dermatitis, but they don't treat the source of the problem. So, what causes dermatitis? In many cases, skin issues actually arise from problems in the gut.
Seventy percent of the immune system is in the gut in the form of immune cells and microbes that help fight infection and modulate how the immune system works. Everything from a poor diet to stress to medications can hurt the gut biome.
Worse still, inflammation in the intestines can cause leaky gut syndrome. When this happens, small pieces of food slip through the gut lining and into the bloodstream. This causes the immune system to react. If it happens often enough, it can cause the immune system to become hyperreactive and produce too many inflammatory compounds, which can cause skin, joint, and digestive issues.
Luckily, there are many ways you can support a healthy gut biome and reduce leaky gut symptoms.
Probiotics
A quality probiotic supplement that contains soil-based microbes can do wonders to help rebalance the gut biome. These probiotics are more robust than many other probiotics on the market and have a higher survival rate as they move through the stomach and into the large intestine where most of the gut biome exists.
If your dog is on antibiotics or other medications that negatively affect the gut biome (such as corticosteroids or Atopica), I also recommend giving them Saccharomyces Boulardii. This probiotic is not a beneficial bacteria but rather a special type of yeast. It is not affected by antibiotics and can help crowd out bad bacteria to give your dog's gut time to recover.
Feed a Quality, Biologically Appropriate Diet
The best way to support your dog’s gut is to feed a high-quality diet that provides the nutrients dogs are meant to digest. Specifically, your dog’s diet should be high in animal protein and fat. These macronutrients help nourish healthy gut bacteria in dogs, unlike carbohydrates, which can cause inflammation and an overgrowth of bad bacteria.
Also, do what you can to avoid diets with preservatives, chemical additives, and low-quality meats that might contain chemicals like phenobarbital and toxins from bacteria. A homemade raw or fresh-prepared diet is often the best choice for dogs suffering from food and environmental allergies.
Control the Environment
Atopic dermatitis occurs when the immune system creates antibodies to certain compounds. These are typically made in response to environmental allergens like pollen, dust, or dander. In some cases, atopy can occur when food allergies cause systemic inflammation. In either case, it’s important to do what you can to limit your dog’s exposure to anything they’re allergic to.
For food allergies, you may have to perform an elimination diet to determine which ingredients your pet is allergic to. Once you know, avoid feeding them these things at all costs.
Environmental allergies can be much more difficult to avoid, but there are still steps you can take. Using a quality home air purifier can help your pet find relief indoors. When outside, using a bodysuit can help keep allergens from sticking to their fur. Walking only at certain times of the day or only when allergy ratings are low can also be helpful.
Support the Immune System
In the end, the cause of your dog's dermatitis comes down to an overactive immune system. Whether this over-reactivity stems from a leaky gut or a genetic component, there are still steps you can take to support the immune system to reduce inflammation and reactivity.
Omega-3 Fatty Acids
The first step to countering inflammation caused by the immune system is to supplement your dog’s diet with omega-3 fatty acids. Both EPA and DHA help reduce inflammation and C-reactive protein. They are also vital for supporting optimal skin and coat health.
Antioxidants
Atopic dermatitis causes oxidative damage to the skin. Supplementing with antioxidants can help reduce and reverse this damage. Adding steamed dark leafy greens or kelp powder to your dog's meals are both great ways to up their antioxidant load. You can also supplement with high-antioxidant herbs, including ginkgo, dong quai, ginger, and curcumin.
Quercetin
Quercetin is a plant flavonoid with potent antioxidant properties. It’s also a natural antihistamine that is powerful enough to stop anaphylaxis in rats. Thanks to these properties, as well as its anti-inflammatory effects, quercetin can be a powerful ally in the war against atopic dermatitis.
Many fruits, vegetables, and legumes contain quercetin. But for therapeutic use, it's most effective to give your dog a quercetin supplement.
The Final Word on Atopica Use in Dogs
While Atopica is a popular drug for treating atopic dermatitis in dogs, it comes with a range of side effects, is very expensive, and does nothing to treat the underlying cause of the problem. For these reasons, many vets do not recommend its use.
Shawn Messonnier, a holistic veterinarian out of Texas, never uses Atopica or other immunosuppressors for his dermatitis patients. Rather, he focuses on treating the symptoms and causes using the natural approach outlined in the Atopica Alternatives section above. In rare cases, he says, he will prescribe antihistamines or steroids for short-term use in conjunction with these natural approaches until symptoms are controlled enough to discontinue them.
Sources
Archer, T., Boothe, D., Langston, V., Fellman, C., Lunsford, K., & Mackin, A. (2013). Oral cyclosporine Treatment in Dogs: A Review of the literature. Journal of Veterinary Internal Medicine, 28(1), 1–20.
Atopic dermatitis (atopy). (n.d.). Cornell University College of Veterinary Medicine.
Cyclosporine (Oral route). (2024, July 8).
Robson, D. (2003). Review of the pharmacokinetics, interactions and adverse reactions of cyclosporine in people, dogs and cats. Veterinary Record/the Veterinary Record, 152(24), 739–748.
Steffan, J., Parks, C., & Seewald, W. (2005). Clinical trial evaluating the efficacy and safety of cyclosporine in dogs with atopic dermatitis. Journal of the American Veterinary Medical Association, 226(11), 1855–1863.
Veterinary Practice News. (2018, March 23). How to tackle pet skin disorders with holistic care – Veterinary Practice News. Veterinary Practice News.
Sara Seitz worked in the pet industry for over a decade. In addition to being a certified dog trainer, Sara gained experience working as the general manager of a dog daycare and boarding facility, as the creator and manager of a pet sitting company, as a groomer, and as a dog behavior evaluator. She also has a bachelors in animal behavior from CSU. Currently, Sara works as a freelance writer specializing in blog, article and content writing.
