Drug interactions
Cilastatin-imipenem + Cyclosporine
Severity: Moderate
Cilastatin-imipenem and Cyclosporine: moderate interaction.
Last updated
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
Both imipenem and cyclosporine can lower the seizure threshold and cause neurotoxicity, and reports describe tremor, confusion and seizures when they are combined. Changes in cyclosporine concentrations have also been reported, though inconsistently.
What this interaction means in plain words
Cilastatin-imipenem and Cyclosporine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive neurotoxic and proconvulsant effects; any effect on cyclosporine levels is not well established.
What to do
Monitor for tremor, confusion and seizures, and check cyclosporine trough levels during and after imipenem therapy. Consider an alternative antibiotic if neurological symptoms develop.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Cilastatin-imipenem
Frequently asked questions
Can I take Cilastatin-imipenem with Cyclosporine?
MediHelp rates the interaction as moderate. Cilastatin-imipenem and Cyclosporine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both imipenem and cyclosporine can lower the seizure threshold and cause neurotoxicity, and reports describe tremor, confusion and seizures when they are combined. Changes in cyclosporine concentrations have also been reported, though inconsistently.
How serious is the interaction between Cilastatin-imipenem and Cyclosporine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for tremor, confusion and seizures, and check cyclosporine trough levels during and after imipenem therapy. Consider an alternative antibiotic if neurological symptoms develop.
What other medicines interact with Cilastatin-imipenem?
MediHelp also lists interactions of Cilastatin-imipenem with, for example, Divalproex, Ganciclovir, Valproic acid. The full list is on the Cilastatin-imipenem page.
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