Cyclosporine

Avoid coadministration of cyclosporine with aliskiren due to significant interaction risk.

Avoid coadministration of cyclosporine with aliskiren due to significant interaction risk.

Significantly increases atorvastatin plasma levels and risk of myopathy and rhabdomyolysis. Concomitant use is not recommended.

Significantly increases atorvastatin plasma levels and increases risk of myopathy and rhabdomyolysis. Concomitant use is not recommended.

CYP3A4 inhibitor that can increase systemic budesonide concentrations. Avoid use.

Toxicity reported. Dual inhibitor of P-glycoprotein and CYP3A4 causing life-threatening or fatal colchicine toxicity, especially in patients with renal or hepatic impairment.

Strong P-glycoprotein inhibitor causing significant increase in colchicine plasma levels. Contraindicated.

Contraindicated due to increased risk of myopathy and rhabdomyolysis with ezetimibe and simvastatin tablets.

Cyclosporine increases fluvastatin exposure, increasing risk of myopathy and rhabdomyolysis. Avoid concomitant use.

Mifepristone increases cyclosporine exposure; concomitant use is contraindicated due to narrow therapeutic range.

Should not be used concomitantly with natalizumab due to potential increased risk of PML and other infections.

Should not be used concomitantly with natalizumab due to increased risk of PML and other infections in Crohn's disease patients.

Cyclosporine significantly increases pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Concomitant use is contraindicated.

Cyclosporine significantly increases pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Concomitant use is contraindicated.

Cyclosporine significantly increases pitavastatin exposure and increases the risk of myopathy and rhabdomyolysis. Concomitant use is contraindicated.

Concurrent use increases risk of severe and potentially fatal hyperkalemia. Avoid use; if unavoidable, closely monitor serum potassium concentrations.

Immunosuppressant that increases serum potassium, raising risk of severe and potentially fatal hyperkalemia. Avoid use; if unavoidable, monitor serum potassium.

Concurrent use increases risk of severe and potentially fatal hyperkalemia. Avoid use; if unavoidable, closely monitor serum potassium concentrations.

Strong P-glycoprotein inhibitor that may increase plasma silodosin concentration. Concomitant use is not recommended.

Increases risk of myopathy and rhabdomyolysis when used with simvastatin. Concomitant use is contraindicated.

Marked but reversible nephrotoxicity reported with coadministration in renal transplant recipients.

Immunosuppressive drug with risk of added immunosuppression. Concomitant use with XELJANZ/XELJANZ XR is not recommended.

Allopurinol increases cyclosporine concentrations, increasing risk of adverse reactions. Increase monitoring frequency and adjust cyclosporine dosage.

Risk of hyperkalemia may be increased when amiloride HCl is administered concomitantly. Use with caution and frequent monitoring of serum potassium.

Increases plasma levels of cyclosporine resulting in elevated creatinine. Monitor cyclosporine drug levels and renal function.

Amlodipine may increase systemic exposure of cyclosporine. Frequent monitoring of trough blood levels and dose adjustment recommended.

Increased risk of myopathy and rhabdomyolysis with atorvastatin; amlodipine may increase systemic exposure of cyclosporine.

Amlodipine may increase systemic exposure of cyclosporine. Frequent monitoring of trough blood levels and dose adjustment recommended.

Amlodipine may increase systemic exposure of cyclosporine. Frequent monitoring of trough blood levels and dose adjustment recommended.

Nephrotoxic agent that may enhance potential for drug-induced renal toxicity. Use concomitantly only with great caution and intensive monitoring of renal function.

Increased activity of both agents may occur concurrently. Convulsions have been reported.

Chloroquine can cause sudden increase in serum cyclosporine levels; close monitoring is recommended and chloroquine may need discontinuation.

BSEP inhibitor that may exacerbate accumulation of conjugated bile salts in liver. Avoid concomitant use; if necessary, monitor serum transaminases and bilirubin.

Potent BCRP, ENT1, and CNT3 transporter inhibitor may alter cladribine bioavailability, intracellular distribution, and renal elimination.

Colesevelam may decrease exposure of cyclosporine. In vivo studies showed decreased cyclosporine exposure when coadministered with colesevelam.

Colesevelam may decrease cyclosporine exposure. In vivo studies showed decreased exposure when coadministered.

Cyclophosphamide may decrease serum concentrations of cyclosporine, resulting in increased incidence of graft-versus-host disease.

Cyclophosphamide may decrease serum concentrations of cyclosporine, resulting in increased incidence of graft-versus-host disease.

Danazol raises plasma levels of cyclosporin, leading to increased renal toxicity. Monitoring and dose adjustments may be needed.

Increased activity of both cyclosporine and corticosteroids may occur concurrently, with convulsions reported.

Increased activity of both cyclosporine and dexamethasone may occur; convulsions have been reported with concurrent use.

Increased activity of both cyclosporine and dexamethasone may occur; convulsions have been reported with concurrent use.

Increased activity of both cyclosporine and dexamethasone may occur with concurrent use; convulsions have been reported.

When coadministered with cyclosporine in rheumatoid arthritis patients, the AUC of diclofenac was significantly increased.

Diclofenac may affect renal prostaglandins and increase cyclosporine nephrotoxicity. Caution advised with concomitant use.

NSAIDs concomitantly administered with cyclosporine have been associated with increased cyclosporine-induced toxicity. Renal function should be carefully monitored.

Etodolac may cause elevated serum levels and increased toxicity of cyclosporine. Nephrotoxicity associated with cyclosporine may be enhanced.

High-dose cyclosporin A (concentrations >2000 ng/mL) increases etoposide exposure by 80% and decreases total body clearance by 38%, potentially increasing etoposide toxicity.

Significantly increases everolimus Cmax and AUC. Dose adjustment of everolimus may be needed if cyclosporine dose is altered.

Cyclosporine significantly increases everolimus Cmax and AUC; dose adjustment of everolimus may be needed if cyclosporine dose is altered.

Combination increases exposure of ezetimibe and cyclosporine. Cyclosporine concentrations should be monitored; effect may be greater in severe renal insufficiency.

Risk of nephrotoxicity and deterioration of renal function due to decreased creatinine clearance. Requires careful benefit-risk assessment and renal function monitoring.

Immunosuppressant can produce nephrotoxicity and decreased creatinine clearance, increasing risk of renal function deterioration with fenofibric acid. Monitor renal function and use lowest effective dosage.

Cyclosporine increases fluvastatin exposure. Fluvastatin dose should be limited to 20 mg twice daily.

Concomitant use should be avoided due to additive nephrotoxicity and renal impairment risk.

Concomitant use is associated with increased risk of gouty arthritis secondary to furosemide-induced hyperuricemia and cyclosporine impairment of renal urate excretion.

Increased risk of nephrotoxicity and potential increase in serum creatinine. Monitor renal function.

Coadministration may increase risk of nephrotoxicity and serum creatinine elevation. Monitor renal function closely.

Increased activity of both drugs; convulsions reported with concurrent use. Monitor patients receiving both agents.

Increased activity of both cyclosporine and corticosteroids may occur; convulsions have been reported.

Increased activity of both cyclosporine and corticosteroids may occur concurrently. Convulsions have been reported with concurrent use.

Concomitant administration of indomethacin with cyclosporine has been associated with increased cyclosporine-induced toxicity and requires careful renal function monitoring.

Increased activity of both cyclosporine and corticosteroids may occur concurrently, with reports of convulsions.

Concomitant use increases risk of myopathy and rhabdomyolysis.

Nephrotoxic drug that increases risk of renal failure when used concomitantly with mannitol; avoid use if possible.

Increased activity of both cyclosporine and corticosteroids may occur when used concurrently. Convulsions have been reported.

Severe renal impairment reported in patients treated with high-dose IV melphalan followed by standard oral cyclosporine doses.

Severe renal failure has been reported when IV melphalan is followed by standard oral doses of cyclosporine.

When coadministered with cyclosporine in rheumatoid arthritis patients, the AUC of methotrexate was significantly increased.

Mutual inhibition of metabolism occurs with concurrent use; convulsions have been reported with concurrent use of methylprednisolone and cyclosporin.

Increased activity of both drugs may occur with concurrent use. Convulsions have been reported with this combination.

Increased activity of both cyclosporine and corticosteroids may occur. Convulsions have been reported with concurrent use.

Increased activity of both cyclosporine and corticosteroids may occur with concurrent use; convulsions have been reported.

Nafcillin results in subtherapeutic cyclosporine levels. Cyclosporine levels should be monitored in organ transplant patients.

Nafcillin concomitant use results in subtherapeutic cyclosporine levels. Cyclosporine levels should be monitored in organ transplant patients.

Nicardipine increases cyclosporine plasma levels through inhibition of hepatic microsomal enzymes including CYP3A4. Cyclosporine dosage should be reduced and plasma concentrations closely monitored.

Nicardipine elevates plasma cyclosporine levels through inhibition of hepatic microsomal enzymes including CYP3A4. Cyclosporine plasma concentrations should be closely monitored and dosage reduced accordingly.

Octreotide may decrease blood levels of cyclosporine and result in transplant rejection due to alterations in nutrient absorption.

Amlodipine increases exposure to cyclosporine, requiring monitoring.

Reduction in cyclosporine plasma levels observed with coadministration. Should not be simultaneously coadministered; cyclosporine should be given 3 hours after orlistat.

Risk of hyperkalemia. Cyclosporine is capable of increasing serum potassium.

Posaconazole increases cyclosporine whole blood concentrations. Reduce cyclosporine dose to approximately three-fourths and monitor trough concentrations.

Posaconazole increases cyclosporine whole blood concentrations. Reduce cyclosporine dose to approximately three-fourths upon initiation and monitor trough concentrations frequently.

Concurrent use increases risk of severe and potentially fatal hyperkalemia, particularly in presence of other hyperkalemia risk factors.

Increases risk of severe and potentially fatal hyperkalemia, particularly in presence of other risk factors. Avoid use if possible.

Increased risk of myopathy and rhabdomyolysis. Pravastatin sodium dose should not exceed 20 mg once daily.

Concurrent use increases activity of both cyclosporin and corticosteroids with convulsions reported.

Increased activity of both drugs may occur with concurrent use. Convulsions have been reported with this combination.

Cyclosporine increases sirolimus concentrations. Sirolimus should be taken 4 hours after cyclosporine administration. Dose adjustment may be needed if cyclosporine is withdrawn.

Cyclosporine increased repaglinide exposures by 2.5 fold. Limit daily maximum dose to 6 mg and increase glucose monitoring frequency.

OATP1B1 and OATP1B3 inhibitor that may increase systemic exposure of revefenacin's active metabolite. Coadministration not recommended.

Cyclosporine increased rosuvastatin exposure 7-fold, significantly increasing the risk of myopathy and rhabdomyolysis. Do not exceed rosuvastatin 5 mg once daily.

Cyclosporine increases rosuvastatin exposure 7-fold. Limit rosuvastatin dose to 5 mg once daily.

Cyclosporine increases hyperkalemia risk; avoid use due to potassium content or monitor serum potassium concentrations.

Increased risk of severe and potentially fatal hyperkalemia when potassium chloride solution is administered.

OATP inhibitor that may substantially increase exposure of voxilaprevir. Coadministration is not recommended.

NSAIDs have been associated with increased cyclosporine-induced toxicity; renal function should be carefully monitored.

May potentiate renal dysfunction; close monitoring of renal function recommended during concomitant use.

Tigecycline may increase serum trough concentrations of cyclosporine, leading to risk of toxicity. Monitor serum concentrations during treatment.

CYP3A4 inhibitor that increases tolterodine plasma concentrations. Dose reduction to 1 mg twice daily recommended.

Increased activity of both cyclosporine and corticosteroids may occur; convulsions have been reported.

Increased activity of both drugs may occur concurrently; convulsions have been reported with concurrent use.

Risk of nephrotoxicity may be increased when coadministered with valganciclovir. Monitor renal function closely.

Potential increase in serum creatinine and nephrotoxicity risk when coadministered with valganciclovir. Monitor renal function.

CYP3A4 inhibitor that increases warfarin effect and INR; requires close monitoring.

Acetazolamide may elevate cyclosporine levels.

Acetazolamide may elevate cyclosporine levels.

Acetazolamide may elevate cyclosporine levels.

Monitoring of drug concentration recommended upon initiation or discontinuation of HUMIRA; dose adjustment may be needed.

ADALIMUMAB-AACF may influence CYP450 enzyme formation, affecting cyclosporine metabolism. Monitoring of cyclosporine concentration is recommended upon initiation or discontinuation of ADALIMUMAB-AACF.

Adalimumab may influence CYP450 enzyme formation. Monitoring of drug concentration and dose adjustment recommended.

Adalimumab-adaz may suppress CYP450 enzyme formation, potentially affecting cyclosporine concentration. Monitoring and dose adjustment recommended.

CYP450 enzyme formation may be suppressed by adalimumab-adbm. Monitoring of drug concentration recommended upon initiation or discontinuation.

Adalimumab may influence CYP450 enzyme formation, affecting cyclosporine concentration. Monitoring of drug concentration and dose adjustment recommended.

YUSIMRY may suppress CYP450 enzyme formation; monitor cyclosporine concentration and adjust dose as needed upon initiation or discontinuation.

AMJEVITA may influence CYP450 enzyme formation; monitoring of cyclosporine concentration and dose adjustment recommended.

HADLIMA may influence CYP450 enzyme formation; monitoring of cyclosporine concentration recommended with dose adjustment as needed.

Adalimumab-fkjp may influence CYP450 enzyme formation; monitoring of cyclosporine concentration recommended with dose adjustment as needed.

Adalimumab-ryvk may suppress CYP450 enzyme formation, affecting cyclosporine concentration. Monitor concentration and adjust dose as needed.

P-glycoprotein inhibitor that increases afatinib exposure. Reduce GILOTRIF dose by 10 mg per day if not tolerated.

Allopurinol increases cyclosporine concentrations, raising risk of adverse reactions. Increase monitoring frequency.

Cyclosporine increases ambrisentan exposure approximately 2-fold. Limit ambrisentan dose to 5 mg once daily when coadministered with cyclosporine.

Risk of hyperkalemia may be increased when used concomitantly with amiloride HCl. Requires caution and frequent monitoring of serum potassium.

Increases cyclosporine concentrations. Dosage adjustment essential.

Amlodipine may increase systemic exposure of cyclosporine. Frequent monitoring of trough blood levels and dose adjustment recommended.

Blood levels of cyclosporine may be reduced when used with armodafinil. Monitoring of circulating cyclosporine concentrations and dosage adjustment should be considered.

NSAID that may potentiate renal dysfunction with cyclosporine, particularly in dehydration. Close monitoring required.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Cyclosporine used in triple-therapy regimens with basiliximab; no dose adjustment necessary. Total body clearance of basiliximab was reduced when combined with other agents.

Concomitant use increases ezetimibe and cyclosporine concentrations, with greater increases in severe renal insufficiency. Monitor cyclosporine concentrations.

Fibric acid derivative may potentiate renal dysfunction with cyclosporine. Close monitoring required.

BIMKELX may modulate serum cytokine levels, altering CYP450 enzyme formation and affecting cyclosporine metabolism. Monitor drug concentration and consider dosage modification.

BLINATUMOMAB causes transient cytokine release that may suppress CYP450 enzymes, potentially increasing cyclosporine concentrations. Monitor drug levels during first 9 days of first cycle and first 2 days of second cycle.

Decreases cyclosporine concentrations; appropriate dosage adjustment required.

OATP1B1/1B3 inhibitor increases brincidofovir AUC and Cmax, may increase adverse reactions. Monitor for elevations in transaminases, bilirubin, diarrhea, or GI events.

SILIQ may modulate serum levels of cytokines affecting CYP450 enzyme formation, potentially altering cyclosporine metabolism. Monitor drug concentration and consider dosage modification upon initiation or discontinuation of SILIQ.

Increases cyclosporine concentrations. Dosage adjustment essential.

Anticonvulsant that decreases cyclosporine concentrations. Dosage adjustment required.

Carvedilol may increase cyclosporine trough concentrations; approximately 30% of patients required cyclosporine dose reduction; close monitoring recommended.

Carvedilol initiation increases mean trough cyclosporine concentrations by about 20% on average; dose reduction may be needed.

Cyclosporine increases AUC of caspofungin acetate. Transient increases in liver ALT and AST occur with concomitant use. Monitor liver enzymes and evaluate risk/benefit.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

Co-administration may cause transient elevations in serum creatinine; monitor renal function.

Transient elevations in serum creatinine may occur. Monitor renal function and serum creatinine.

Transient elevations in serum creatinine may occur. Monitor renal function and serum creatinine when co-administered.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Lower serum concentrations of cyclosporine observed with concomitant cyclophosphamide, potentially reducing cyclosporine efficacy.

Increases cyclosporine concentrations. Dosage adjustment essential.

Deferasirox may induce CYP3A4 resulting in decreased cyclosporine concentration. Monitor for reduced effectiveness.

Oral contraceptives may inhibit metabolism of cyclosporine, increasing its plasma concentrations.

CYP3A4 substrate; diazepam may interfere with its metabolism, leading to potential drug-drug interaction.

Monitor for signs of worsening renal function during concomitant use.

Increases digoxin concentrations; magnitude unclear. Requires monitoring and dose adjustment.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

May require dosage adjustment due to competitive inhibition of metabolism. Particularly important in renal and/or hepatic impairment due to low therapeutic ratio.

Highly protein-bound drug with narrow therapeutic index; dronabinol may displace cyclosporine from plasma proteins increasing free fraction. Monitor for adverse reactions.

OATP1B1 inhibitor that increases eluxadoline exposure. Requires dose reduction to 75 mg twice daily and monitoring for adverse reactions.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Etonogestrel may increase plasma concentrations of cyclosporine.

Cyclosporine inhibits P-glycoprotein, significantly increasing plasma concentrations of fidaxomicin and its metabolite OP-1118, though no dose adjustment is recommended based on clinical trial safety data.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

Glyburide may increase cyclosporine plasma concentration and potentially lead to its increased toxicity. Monitoring and dosage adjustment recommended.

Glycerol phenylbutyrate may decrease systemic exposure. Monitor for decreased efficacy of this narrow therapeutic index drug.

Golimumab may normalize CYP450 enzyme formation, potentially affecting cyclosporine metabolism. Monitoring and dose adjustment recommended.

Affects cyclosporine metabolism, increasing blood concentrations. Should be avoided.

Griseofulvin may reduce cyclosporine levels, resulting in decreased pharmacologic effects.

Increased plasma cyclosporine levels reported; close monitoring of serum levels necessary.

Increased plasma cyclosporin levels were reported when co-administered with hydroxychloroquine sulfate.

Increases cyclosporine concentrations. Dosage adjustment essential.

HIV protease inhibitor that inhibits CYP3A4 and may increase cyclosporine concentrations. Care should be exercised; dosage monitoring required.

Monitoring of drug concentration recommended upon initiation or discontinuation of infliximab; individual dose adjustment may be needed.

Monitoring of drug concentration recommended upon initiation or discontinuation of AVSOLA; individual dose adjustment may be needed.

TNF blocker may normalize CYP450 enzyme formation, potentially decreasing cyclosporine exposure. Monitor drug concentration and adjust dosage upon initiation or discontinuation.

Increase in cyclosporine exposure. Monitor drug concentrations and adjust dose as needed.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Increases cyclosporine concentrations via CYP3A4 inhibition. Also may potentiate renal dysfunction. Dosage adjustment essential.

Lanreotide may decrease the absorption of cyclosporine, necessitating dosage adjustment to maintain therapeutic concentrations.

Co-administration requires dosage adjustment of letermovir to 240 mg once daily in adults and pediatric patients ≥12 years; dose adjustment may be needed in younger patients.

Immunosuppressant may increase risk of hyperkalemia when used with CLINIMIX E due to its potassium content; administer with caution.

COCs containing ethinyl estradiol may inhibit the metabolism of cyclosporine.

Increased plasma concentrations reported with concomitant administration of oral contraceptives containing ethinyl estradiol.

Cyclosporine induces renal losses of magnesium.

Cyclosporine induces renal losses of magnesium, potentially leading to hypomagnesemia.

May affect renal prostaglandins, altering renal toxicity of cyclosporine.

Methylene blue inhibits CYP3A4/5 metabolism. Cyclosporine has narrow therapeutic index; clinical relevance unknown but concurrent use requires caution.

Metoclopramide may increase the rate and/or extent of absorption of cyclosporine from the small bowel.

Metoclopramide may increase the rate and/or extent of absorption of cyclosporine from the small bowel.

Metreleptin may alter CYP450 metabolism of cyclosporine. Drug concentration monitoring and dose adjustment recommended upon initiation or discontinuation.

CYP3A4 substrate whose plasma levels may increase with concomitant metronidazole use. Monitor plasma concentrations.

Blood levels of cyclosporine may be reduced when used with modafinil. Monitoring of circulating concentrations and dosage adjustment should be considered.

May decrease MPA concentrations; exercise caution when switching between drugs.

Interferes with enterohepatic recirculation, decreasing mycophenolate mofetil systemic exposure. Monitor for alterations in efficacy.

Interferes with enterohepatic recirculation, decreasing mycophenolic acid systemic exposure and potentially reducing Mycophenolate Mofetil efficacy. Monitor for alterations.

P-glycoprotein inhibitor increasing plasma naldemedine concentrations; monitor for adverse reactions.

NSAID that may potentiate renal dysfunction with cyclosporine, particularly in dehydration. Close monitoring required.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

HIV protease inhibitor that inhibits CYP3A4 and may increase cyclosporine concentrations. Care should be exercised; dosage monitoring required.

Moderate CYP3A4 inhibitor that may increase nimodipine plasma concentration and blood pressure lowering effect. Blood pressure monitoring and dose reduction of nimodipine may be necessary.

CHCs may inhibit metabolism and increase plasma concentrations of cyclosporine.

Systemic concentrations of cyclosporine may increase due to hormonal contraceptive effects on metabolism.

Oral contraceptives may inhibit metabolism of cyclosporine, increasing its plasma concentrations.

Oral contraceptives may inhibit metabolism of cyclosporine, increasing its plasma concentrations.

COCs containing ethinyl estradiol may inhibit metabolism of cyclosporine, potentially increasing its plasma concentrations.

Ethinyl estradiol may inhibit the metabolism of cyclosporine and increase its plasma concentrations.

Octreotide decreases cyclosporine bioavailability; dose adjustment of cyclosporine may be necessary.

Concomitant use with systemic quinolones has been associated with transient elevations in serum creatinine.

Concomitant systemic quinolone administration is associated with transient elevations in serum creatinine.

Amlodipine increases exposure to cyclosporin.

Omeprazole can prolong elimination of cyclosporine. Monitor and determine need for dose adjustments.

Omeprazole and sodium bicarbonate can prolong cyclosporine elimination. Monitor for possible dose adjustments.

Increase cyclosporine concentrations. Dosage adjustment essential.

Decreases cyclosporine concentrations; appropriate dosage adjustment required.

Sensitive CYP3A substrate with narrow therapeutic index. Dose may need reduction when coadministered with palbociclib.

PALSONIFY decreases cyclosporine bioavailability. Adjustment of cyclosporine dose to maintain therapeutic levels may be necessary with therapeutic drug monitoring.

Concomitant administration may decrease the relative bioavailability of cyclosporine; dose adjustment may be necessary to maintain therapeutic levels.

Increases cyclosporine concentrations. Dosage adjustment essential.

Antibiotic combination that increases cyclosporine concentrations. Dosage adjustment required.

Rabeprazole inhibits cyclosporine metabolism in vitro with potential for increased cyclosporine levels.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

P-gp inhibitor that increases ranolazine exposure. Titrate ranolazine based on clinical response.

Decreases cyclosporine concentrations; appropriate dosage adjustment required.

P-glycoprotein inhibitor that significantly increased systemic exposure of rifaximin. In hepatic impairment, potential additive effect of reduced metabolism may further increase rifaximin exposure. Caution should be exercised.

Potent P-gp inhibitor that may increase rimegepant exposure. Avoid another dose within 48 hours when co-administered.

HIV protease inhibitor that inhibits CYP3A4 and may increase cyclosporine concentrations. Care should be exercised; dosage monitoring required.

HIV protease inhibitor that inhibits CYP3A4 and may increase cyclosporine concentrations. Care should be exercised; dosage monitoring required.

Cyclosporine (dual/multiple inhibitor of OATP1B1, OATP1B3, BCRP) increases seladelpar exposure. Monitor for adverse effects.

Sevelamer carbonate may reduce bioavailability of cyclosporine, which could have clinically significant effect on safety or efficacy. Consider separation of administration timing.

Reduction in bioavailability may have clinically significant effect on safety or efficacy; consider separation of administration timing.

Sevelamer may reduce bioavailability of cyclosporine, which has clinically significant effects on safety or efficacy. Consider separation of administration timing.

SILTUXIMAB may restore CYP450 activities leading to increased metabolism of cyclosporine. Drug concentration monitoring and dose adjustment recommended upon initiation or discontinuation.

Avoid use due to potassium content increasing risk of hyperkalemia. If unavoidable, monitor serum potassium concentrations.

Somatropin may alter clearance of cyclosporine metabolized by CYP450 liver enzymes; careful monitoring is advised.

May potentiate renal dysfunction when used with trimethoprim and cyclosporine. Close monitoring required.

Amlodipine may increase systemic exposure of cyclosporine. Monitor accordingly.

Terbinafine increases clearance of cyclosporine by 15%. Monitor cyclosporine levels.

Terbinafine increases cyclosporine clearance by 15%, potentially decreasing cyclosporine exposure. Monitoring recommended.

Terbinafine increases the clearance of cyclosporine by 15%.

GH may alter clearance of cyclosporine metabolized by CYP450 liver enzymes; monitor for potential interactions.

Tinidazole may increase cyclosporine levels. Monitor for signs of calcineurin-inhibitor associated toxicities during co-administration.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

Tocilizumab may affect cyclosporine concentrations; therapeutic drug monitoring and dose adjustment recommended upon initiation or discontinuation.

Tocilizumab may affect cyclosporine exposure; monitor drug concentration and adjust dose as needed.

In vitro data of benzodiazepines suggest possible drug interaction with triazolam. Caution recommended.

May potentiate renal dysfunction when used with sulfamethoxazole and cyclosporine. Close monitoring required.

Moderate CYP3A4 inhibitor. Dose adjustment recommended with concomitant use.

Cyclosporine is an inhibitor of hepatic uptake transporter OATP1B1, which may increase systemic exposure to valsartan.

Co-administration of cyclosporine (uptake transporter inhibitor) may increase systemic exposure to valsartan.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Verapamil therapy may increase serum levels of cyclosporin.

Increases cyclosporine concentrations via CYP3A4 inhibition. Dosage adjustment essential.

Amlodipine may increase systemic exposure of cyclosporine. Frequent monitoring of trough blood levels and dose adjustment recommended.

Co-administration resulted in no significant alteration in steady state pharmacokinetics of either drug. No dosage adjustment needed.

Co-administration with micafungin did not alter cyclosporine pharmacokinetics.

No pharmacokinetic interaction observed; however, caution recommended due to potential additive immune effects.

In vivo testing showed no clinically meaningful interaction between LOKELMA and cyclosporine.

When coadministering ambrisentan with cyclosporine, the ambrisentan dose should not be titrated to the recommended maximum daily dose Anthracycline antibiotics High doses of cyclosporine (e.g., at starting intravenous dose of 16 mg/kg/day) may increase the exposure to anthracycline antibiotics (e.g., doxorubicin, mitoxantrone, daunorubicin) in cancer patients.

HMG-CoA reductase inhibitors (statins) Literature and postmarketing cases of myotoxicity, including muscle pain and weakness, myositis, and rhabdomyolysis, have been reported with concomitant administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and, rarely fluvastatin.

Boceprevir Coadministration of boceprevir (800 mg three times daily for 7 days) and cyclosporine (100 mg single dose) in healthy subjects resulted in increases in the mean AUC and C max of cyclosporine approximately 2.7-fold and 2-fold, respectively, compared to when cyclosporine was given alone.

Nifedipine Frequent gingival hyperplasia when nifedipine is given concurrently with cyclosporine has been reported. The concomitant use of nifedipine should be avoided in patients in whom gingival hyperplasia develops as a side effect of cyclosporine.

HMG-CoA reductase inhibitors (statins) Literature and postmarketing cases of myotoxicity, including muscle pain and weakness, myositis, and rhabdomyolysis, have been reported with concomitant administration of cyclosporine with lovastatin, simvastatin, atorvastatin, pravastatin, and, rarely fluvastatin.

Drugs That Increase Cyclosporine Concentrations Calcium Channel Blockers Antifungals Antibiotics Glucocorticoids Other Drugs diltiazem fluconazole azithromycin methylprednisolone Allopurinol nicardipine itraconazole clarithromycin Amiodarone verapamil ketoconazole erythromycin Bromocriptine voriconazole quinupristin/ dalfopristin colchicine danazol imatinib metoclopramide nefazodone oral contraceptives HIV Protease inhibitors The HIV protease inhibitors (e.g., indinavir, nelfinavir, ritonavir, and saquinavir) are known to inhibit cytochrome P-450 3A and thus could potentially increase the concentrations of cyclosporine, however no formal studies of the interaction are available. Cyclosporine may reduce the clearance of digoxin, colchicine, prednisolone, HMG-CoA reductase inhibitors (statins), and, aliskiren, bosentan, dabigatran, repaglinide, NSAIDs, sirolimus, etoposide, and other drugs. Methylprednisolone Convulsions when high dose methylprednisolone is given concurrently with cyclosporine have been reported.

Telaprevir Coadministration of telaprevir (750 mg every 8 hours for 11 days) with cyclosporine (10 mg on day 8) in healthy subjects resulted in increases in the mean dose-normalized AUC and C max of cyclosporine approximately 4.5-fold and 1.3-fold, respectively, compared to when cyclosporine (100 mg single dose) was given alone.