Drug interactions
Cyclosporin + Irinotecan
Severity: Major
Cyclosporin and Irinotecan: 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
Cyclosporine can raise exposure to irinotecan and its active metabolite SN-38, increasing the risk of severe diarrhea and myelosuppression. Irinotecan clearance depends on CYP3A4, transporters and biliary excretion.
What this interaction means in plain words
Cyclosporin and Irinotecan 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; Irinotecan belongs to Oncology.
Why it happens
Cyclosporine inhibits P-glycoprotein, MRP2 and CYP3A4, reducing irinotecan and SN-38 clearance.
What to do
Avoid concurrent use where possible, or reduce the irinotecan dose. Monitor closely for diarrhea and neutropenia with regular blood counts.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cyclosporin and Irinotecan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Irinotecan
- Clozapine + Irinotecan Contraindicated
- Irinotecan + Sacituzumab govitecan Contraindicated
- Adenovirus types 4 and 7 live + Irinotecan Major
- Apalutamide + Irinotecan Major
- Atazanavir + Irinotecan Major
- Carbamazepine + Irinotecan Major
Frequently asked questions
Can I take Cyclosporin with Irinotecan?
MediHelp rates the interaction as major. Cyclosporin and Irinotecan 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. Cyclosporine can raise exposure to irinotecan and its active metabolite SN-38, increasing the risk of severe diarrhea and myelosuppression. Irinotecan clearance depends on CYP3A4, transporters and biliary excretion.
How serious is the interaction between Cyclosporin and Irinotecan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible, or reduce the irinotecan dose. Monitor closely for diarrhea and neutropenia with regular blood counts.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
