Drug interactions
Cyclosporin + Erythromycin ethylsuccinate
Severity: Major
Cyclosporin and Erythromycin ethylsuccinate: 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
Erythromycin raises cyclosporine concentrations markedly, risking kidney injury, neurotoxicity and hypertension. Cyclosporine may also raise erythromycin exposure, adding QT and gastrointestinal effects.
What this interaction means in plain words
Cyclosporin and Erythromycin ethylsuccinate 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.
What to do
Prefer an alternative antibiotic such as azithromycin. If unavoidable, monitor cyclosporine trough levels and serum creatinine and lower the cyclosporine dose as required.
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
Frequently asked questions
Can I take Cyclosporin with Erythromycin ethylsuccinate?
MediHelp rates the interaction as major. Cyclosporin and Erythromycin ethylsuccinate 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 raises cyclosporine concentrations markedly, risking kidney injury, neurotoxicity and hypertension. Cyclosporine may also raise erythromycin exposure, adding QT and gastrointestinal effects.
How serious is the interaction between Cyclosporin and Erythromycin ethylsuccinate?
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 an alternative antibiotic such as azithromycin. If unavoidable, monitor cyclosporine trough levels and serum creatinine and lower the cyclosporine dose as required.
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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