Drug interactions
Cyclosporin + Erythromycin base
Severity: Major
Cyclosporin and Erythromycin base: major 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
Erythromycin substantially raises cyclosporine blood concentrations, causing nephrotoxicity, neurotoxicity and hypertension. Cyclosporine may also increase erythromycin levels, adding to its QT and gastrointestinal effects.
What this interaction means in plain words
Cyclosporin and Erythromycin base 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
Erythromycin inhibits CYP3A4 and P-glycoprotein, decreasing cyclosporine metabolism and efflux; cyclosporine may reciprocally impair erythromycin clearance.
What to do
Prefer a non-interacting antibiotic such as azithromycin. If used, reduce cyclosporine dose as needed with close trough monitoring and renal function checks, and recheck after stopping erythromycin.
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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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
Frequently asked questions
Can I take Cyclosporin with Erythromycin base?
MediHelp rates the interaction as major. Cyclosporin and Erythromycin base 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. Erythromycin substantially raises cyclosporine blood concentrations, causing nephrotoxicity, neurotoxicity and hypertension. Cyclosporine may also increase erythromycin levels, adding to its QT and gastrointestinal effects.
How serious is the interaction between Cyclosporin and Erythromycin base?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-interacting antibiotic such as azithromycin. If used, reduce cyclosporine dose as needed with close trough monitoring and renal function checks, and recheck after stopping erythromycin.
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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