Drug interactions
Cyclosporin + Diltiazem
Severity: Major
Cyclosporin and Diltiazem: 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
Diltiazem raises cyclosporine blood concentrations, increasing the risk of nephrotoxicity if the dose is not adjusted. The combination is sometimes used deliberately to reduce cyclosporine dose requirements, and additive hypotension may occur.
What this interaction means in plain words
Cyclosporin and Diltiazem 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.
Cyclosporin belongs to Miscellaneous; Diltiazem belongs to Cardiovascular.
Why it happens
Diltiazem inhibits CYP3A4 and P-glycoprotein, reducing cyclosporine clearance.
What to do
Monitor cyclosporine trough levels and renal function when diltiazem is started, changed or stopped, reduce the cyclosporine dose as needed, and monitor blood pressure.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
Other interactions of Diltiazem
- Diltiazem + Flibanserin Contraindicated
- Diltiazem + Ivabradine Contraindicated
- Diltiazem + Lomitapide Contraindicated
- Diltiazem + Lonafarnib Contraindicated
- Acebutolol + Diltiazem Major
- Alfentanil + Diltiazem Major
Frequently asked questions
Can I take Cyclosporin with Diltiazem?
MediHelp rates the interaction as major. Cyclosporin and Diltiazem 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. Diltiazem raises cyclosporine blood concentrations, increasing the risk of nephrotoxicity if the dose is not adjusted. The combination is sometimes used deliberately to reduce cyclosporine dose requirements, and additive hypotension may occur.
How serious is the interaction between Cyclosporin and Diltiazem?
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 and renal function when diltiazem is started, changed or stopped, reduce the cyclosporine dose as needed, and monitor blood pressure.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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