bpc-157 psoriasis: Frequently asked questions

Cyclosporine has a range of side effects. Minor ones include:

Cyclosporine comes in pill or liquid form. You have to take it consistently for it to work. You also need to dilute liquid cyclosporine with orange or apple juice before you take it. Never mix it with grapefruit juice, which can cause your body to absorb too much of the drug. You may start out with a low dose and increase it or start out with a higher dose and decrease it. Make sure you know what your dose is and when to take it before you start this drug.

Apremilast comes in pill form. Most often, you’ll increase your dose slowly over the first 5 days, working up to two 30-milligram tablets twice a day. This slow increase helps reduce side effects. It’s important to swallow apremilast pills whole. Don’t chew, split, or crush them.

There are many different kinds of immunomodulators. Doctors have used some, such as methotrexate and cyclosporine, for many years. There are also a slew of newer types, such as the dozen or so biologics approved for psoriasis. If one immunomodulator doesn’t clear or nearly clear your skin after you’ve taken it for the recommended amount of time, ask your doctor to prescribe something else. With so many treatment options for psoriasis, there’s no reason to live with its symptoms.

Methotrexate can cause your white blood cell count to drop, which raises your risk of infection. Liver damage is a serious concern with methotrexate. Your risk for this is higher if you:

This drug was originally used to prevent organ rejection after a transplant. Doctors noticed that when they gave cyclosporine to transplant patients who also had psoriasis, it helped clear their skin. It’s used most often for people with severe or disabling psoriasis and tends to work quickly.

Each of the many different biologics approved for psoriasis has its own potential side effects. Common ones include:

These are protein-based drugs created from living cells in a lab. They target the specific cells and proteins that create symptoms of psoriasis. These drugs are less likely to cause problems with your liver, kidneys, or other organs than drugs like methotrexate that suppress your entire immune system. Biologics may stop working over time. If that happens, your doctor can recommend another biologic or switch you to another kind of immunomodulator.

Biologics are given as a shot or through intravenous (IV) infusion. Your doctor may suggest that you combine biologics with other treatments like topicals and light therapy.

Because they suppress some parts of your immune system, biologics can increase your risk for infections. That’s why your doctor will test you for tuberculosis and other infectious diseases before you begin treatment.

Don’t take methotrexate at the same time as antibiotics that contain trimethoprim-sulfa. If you’re prescribed one of these antibiotics, talk to your doctor about how to schedule it with your methotrexate dose. They will probably ask you to hold your methotrexate during treatment with this kind of antibiotic.

“Live” vaccines, or those that contain living viruses, can cause problems if you get them while you’re on a biologic. It’s best to get these vaccines before you start a biologic. Talk to your doctor before you get any sort of vaccine, including a flu shot. It’s important to protect your health with the vaccines you need, however. Your doctor can usually adjust your psoriasis treatment so you can get vaccines safely. You should also check with your doctor before you take any medication they haven't prescribed, including over-the-counter drugs.

Cyclosporine interacts with many different kinds of medications. Make sure your doctor knows about every medication you take, including supplements and over-the-counter drugs. Check first before taking any kind of:

Your doctor can prescribe this drug in a pill or liquid form or as an injection you give yourself at home. Be sure to follow all instructions carefully and ask your doctor or pharmacist any questions you have before you start taking methotrexate.

Don’t take biologics if you have an active infection or serious problems with your immune system. If you are older, have diabetes, smoke, or chew tobacco, your risk of developing a serious infection is higher.

It can cause one or more of these side effects:

Don’t take methotrexate if you drink a lot of alcohol or have liver disease. You should also avoid it if you:

This immunomodulator targets an enzyme in cells that controls inflammation. Unlike some other strong drugs for psoriasis, apremilast doesn’t cause serious side effects that require you to have medical tests while you take it.

Methotrexate lowers your immune system’s activity and blocks cells and enzymes that make your skin cells grow too quickly.

If you’re depressed, apremilast may make it worse. If you’re not, apremilast may cause depression or suicidal thoughts.