Drug interactions
Cyclosporin + Fluconazole
Severity: Major
Cyclosporin and Fluconazole: 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
Fluconazole can raise cyclosporin concentrations, increasing the risk of nephrotoxicity, hypertension and neurotoxicity. The effect is dose-dependent and can persist after fluconazole is stopped.
What this interaction means in plain words
Cyclosporin and Fluconazole 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; Fluconazole belongs to Anti Fungals.
Why it happens
Fluconazole inhibits CYP3A4, decreasing cyclosporin metabolism.
What to do
Monitor cyclosporin trough levels and serum creatinine, and reduce the cyclosporin dose as needed; recheck after fluconazole is discontinued.
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 Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Cyclosporin with Fluconazole?
MediHelp rates the interaction as major. Cyclosporin and Fluconazole 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. Fluconazole can raise cyclosporin concentrations, increasing the risk of nephrotoxicity, hypertension and neurotoxicity. The effect is dose-dependent and can persist after fluconazole is stopped.
How serious is the interaction between Cyclosporin and Fluconazole?
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 cyclosporin trough levels and serum creatinine, and reduce the cyclosporin dose as needed; recheck after fluconazole is discontinued.
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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