Drug interactions
Cyclosporin + Enalapril
Severity: Moderate
Cyclosporin and Enalapril: 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
Cyclosporine may modestly raise exposure to enalapril, which is a prodrug taken up by hepatic transporters. A more clinically relevant concern is that both agents can raise serum potassium and impair renal function, particularly in volume-depleted patients.
What this interaction means in plain words
Cyclosporin and Enalapril 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.
Cyclosporin belongs to Miscellaneous; Enalapril belongs to Cardiovascular.
Why it happens
Possible inhibition of hepatic OATP uptake of enalapril, plus additive hyperkalemic and renal hemodynamic effects of cyclosporine and ACE inhibition.
What to do
Monitor serum potassium and creatinine at the start of therapy and after dose changes. Reduce the enalapril dose or review potassium-raising co-medications if hyperkalemia or a creatinine rise develops.
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 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 Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Cyclosporin with Enalapril?
MediHelp rates the interaction as moderate. Cyclosporin and Enalapril 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. Cyclosporine may modestly raise exposure to enalapril, which is a prodrug taken up by hepatic transporters. A more clinically relevant concern is that both agents can raise serum potassium and impair renal function, particularly in volume-depleted patients.
How serious is the interaction between Cyclosporin and Enalapril?
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 serum potassium and creatinine at the start of therapy and after dose changes. Reduce the enalapril dose or review potassium-raising co-medications if hyperkalemia or a creatinine rise develops.
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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