Drug interactions
Amlodipine-perindopril + Cyclosporine
Severity: Major
Amlodipine-perindopril and Cyclosporine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Cyclosporine may raise amlodipine concentrations through CYP3A4 inhibition, and amlodipine may increase cyclosporine trough levels in some patients. Cyclosporine also causes nephrotoxicity and hyperkalemia, which perindopril can aggravate.
What this interaction means in plain words
Amlodipine-perindopril and Cyclosporine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
CYP3A4 and possibly P-glycoprotein effects alter exposure to both drugs, and perindopril adds to cyclosporine-related hyperkalemia and renal impairment.
What to do
Monitor cyclosporine trough levels, renal function and potassium, and adjust the cyclosporine dose as needed. Monitor blood pressure and edema and reduce the amlodipine dose if needed.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Amlodipine-perindopril
- Aliskiren + Amlodipine-perindopril Contraindicated
- Amlodipine-perindopril + Protein a column Contraindicated
- Amlodipine-perindopril + Sacubitril / valsartan Contraindicated
- Amifostine + Amlodipine-perindopril Major
- Amiloride + Amlodipine-perindopril Major
- Amlodipine-perindopril + Azilsartan Major
Frequently asked questions
Can I take Amlodipine-perindopril with Cyclosporine?
MediHelp rates the interaction as major. Amlodipine-perindopril and Cyclosporine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Cyclosporine may raise amlodipine concentrations through CYP3A4 inhibition, and amlodipine may increase cyclosporine trough levels in some patients. Cyclosporine also causes nephrotoxicity and hyperkalemia, which perindopril can aggravate.
How serious is the interaction between Amlodipine-perindopril and Cyclosporine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporine trough levels, renal function and potassium, and adjust the cyclosporine dose as needed. Monitor blood pressure and edema and reduce the amlodipine dose if needed.
What other medicines interact with Amlodipine-perindopril?
MediHelp also lists interactions of Amlodipine-perindopril with, for example, Aliskiren, Protein a column, Sacubitril / valsartan. The full list is on the Amlodipine-perindopril page.
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