The FDA approved Voclosporin in 2021 to treat adult patients with active lupus nephritis (kidney inflammation due to lupus). Voclosporin is used in combination with other drugs, including (but not limited to) hydroxychloroquine (Plaquenil), glucocorticoids (steroids), and mycophenolate mofetil (CellCept). As most medications for autoimmune conditions, this medication decreases the immune system's strength. In clinical trials for lupus nephritis, those patients receiving voclosporin were twice as likely to respond favorably to treatment (reduced kidney inflammation) than those who did not receive voclosporin.
Voclosporin is a capsule that is taken twice a day. The most common dose includes three capsules taken in the morning and three in the evening (12 hours apart) on an empty stomach. Patients with lupus nephritis who have very low kidney function or very high blood pressure may not be able to start this drug. Blood tests are needed to monitor changes in kidney function and potassium levels. Also, if you start voclosporin, your clinician will ask you to check your blood pressure every two weeks for the first month.
Patients taking vosclosporin should avoid eating grapefruit or drinking grapefruit juice as it increases the levels of voclosporin in your blood.
Patients who develop low kidney function after taking voclosporin should follow up with their healthcare provider to adjust the dose.
Similar to other medications that decrease the strength of the immune system, infections are not an unusual side effect. Voclosporin can increase blood pressure, increase potassium blood levels and cause kidney problems. Prolonged use of voclosporin may increase the risk of some cancers such as lymphoma and skin cancers.
Tell your rheumatology provider if you develop symptoms of an infection, such as a fever, cough, burning with urination, or shingles (red skin rash that causes pain and burning) or if you think you are experiencing any side effects or allergic reactions.
Consult with the rheumatology healthcare provider if you start a new drug since voclosporin can have interactions with other types of drugs.
You should notify your rheumatology provider if you develop symptoms of an infection, such as a fever or cough, or if you think you have any side effects or allergic reactions. Notify your doctor if you have become pregnant, are planning pregnancy, or are breastfeeding. Be sure to talk with your rheumatology provider if you are planning to have surgery as the medication may need to be stopped before surgery to improve recovery. The risk in pregnancy and breastfeeding has not been determined.
Written August 2022 by Alí Duarte-García, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.
This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.