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Lupkynis

Generic name: voclosporinVOE-kloe-SPOR-in ]
Drug class: Calcineurin inhibitors

Medically reviewed by Judith Stewart, BPharm. Last updated on Mar 13, 2023.

What is Lupkynis?

Lupkynis is a calcineurin-inhibitor immunosuppressant medicine.

Lupkynis is a prescription medicine used together with other medicines to treat kidney problems (active lupus nephritis) in adults with system lupus erythematous (SLE).

Lupkynis should not be taken with a medicine called cyclophosphamide. Talk with your healthcare provider if you are not sure if you take this medicine.

Lupkynis is supplied as an oval pink/orange capsule, imprinted on one side with VCS in white ink, packed in aluminum blisters.

Warnings

Taking Lupkynis may increase your risk of certain cancers such as skin cancer or lymphoma.

Voclosporin affects your immune system. You may get infections more easily, even serious or fatal infections. Call your doctor if you have a fever, chills, sweating, cough, skin sores, muscle aches, or other flu-like symptoms.

Do not take Lupkynis with medicines known as strong CYP3A4 inhibitors such as ketoconazole, itraconazole, and clarithromycin.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

Before taking this medicine

You should not use Lupkynis if you are allergic to voclosporin.

Many drugs can interact and cause dangerous effects. Some drugs should not be used together with Lupkynis. Your doctor may change your treatment plan if you also use:

When taking Lupkynis with other medicine: To make sure all medicines are safe for you, tell your doctor about all your medical conditions, and if you are pregnant or breastfeeding.

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Taking Lupkynis may increase your risk of certain cancers such as skin cancer or lymphoma. Ask your doctor about your specific risk.

Tell your doctor if you are pregnant or plan to become pregnant. Voclosporin contains alcohol and should not be used during pregnancy. However, having untreated active lupus nephritis during pregnancy may cause complications such eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating your kidney problems may outweigh any risks to the baby.

Lupkynis is sometimes used in combination with another medicine called mycophenolate mofetil. Using mycophenolate mofetil during pregnancy can cause a miscarriage or birth defects. Both men and women should use effective birth control to prevent pregnancy during and shortly after treatment with mycophenolate mofetil (women for 6 weeks after and men for 90 days after).

Do not breastfeed while using Lupkynis, and for at least 7 days after your last dose.

How should I take Lupkynis?

Use Lupkynis exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Swallow the capsule whole and do not crush, chew, break, or open it. Tell your doctor if you have trouble swallowing a Lupkynis capsule whole.

Take Lupkynis on an empty stomach, at least 1 hour before or 2 hours after a meal.

Take your doses at regular intervals 12 hours apart. Do not take your doses less than 8 hours apart.

Voclosporin affects your immune system. You may get infections more easily, even serious or fatal infections. You will need frequent medical tests. Your treatment with Lupkynis may be delayed or stopped based on the results.

Your blood pressure will also need to be checked often.

Store Lupkynis in the original container at room temperature, away from moisture and heat.

It is not known if taking Lupkynis is safe or effective for longer than 1 year.

Dosing information

Usual Adult Dose for Lupus Nephritis:

23.7 mg orally twice a day

Comments:
-The use of this drug in combination with cyclophosphamide is not recommended as safety and efficacy have not been established.
-Use this drug in combination with mycophenolate mofetil (MMF) and corticosteroids.
-Determine an actual baseline estimated glomerular filtration rate (eGFR) prior to initiating treatment.
-Dosage of this drug is based on the patient's eGFR and should be modified accordingly.
-Check blood pressure (BP) at baseline and do not initiate treatment in patients with BP greater than 165/105 mmHg or with hypertensive emergency.
-Treatment discontinuation should be considered if the patient does not experience therapeutic benefit by 24 weeks.
-Safety and efficacy have not been established beyond one year.

Use: In combination with a background immunosuppressive therapy regimen for the treatment of adult patients with active lupus nephritis

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if you are more than 4 hours late for the dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include headache, weakness, tremors, vomiting, infections, rash, or fast heartbeats.

What should I avoid while taking Lupkynis?

Do not receive a "live" vaccine while using Lupkynis. The vaccine may not work as well and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Voclosporin could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Grapefruit may interact with voclosporin and lead to unwanted side effects. Avoid the use of grapefruit products.

Lupkynis side effects

Get emergency medical help if you have signs of an allergic reaction to Lupkynis: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

Common Lupkynis side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Lupkynis?

Voclosporin can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Many drugs can interact with voclosporin, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Popular FAQ

Lupkynis (voclosporin) is an expensive drug that has limited distribution, meaning you will receive this medicine from a specialty pharmacy, not your local pharmacy. Specialty drugs may be mailed to your house. A specialty pharmacy can help you access the medicine if prescribed by your doctor, answer insurance questions, and monitor for the drug’s safety and effectiveness.

Yes, hair loss (also called alopecia) has been reported as a common side effect with Lupkynis. In studies, hair loss was reported in 6% of patients treated with Lupkynis 23.7 mg twice a day compared to 3% of patients receiving a placebo (an inactive agent).

No, Lupkynis is not a steroid medicine. It is a calcineurin-inhibitor immunosuppressant that helps to control lupus nephritis and protect the kidneys from inflammation and further permanent damage. It works by calming overactive cells in your immune system that may attack the kidney.

Talk with your healthcare provider if you have been taking Lupkynis for close to one year, as it is not known if it’s safe or effective beyond a year. If you have not had any therapeutic benefit by 24 weeks, your doctor may decide to stop treatment. Continue treatment as long as your doctor recommends. Do not change your dose or stop taking your treatment without talking to your doctor first.

Benlysta is an injectable medicine approved to treat children 5 years of age and older and adults with systemic lupus erythematosus (SLE) and active lupus nephritis (lupus-related kidney inflammation) who are receiving other lupus medicines. Lupkynis is only approved by the FDA to treat lupus nephritis in adults and comes as an oral capsule taken by mouth twice per day. Continue reading

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lupkynis only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.