Drug interactions
Cyclosporin + Istradefylline
Severity: Moderate
Cyclosporin and Istradefylline: 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
At higher doses, istradefylline inhibits CYP3A4 and P-glycoprotein and may increase concentrations of cyclosporine, a narrow-therapeutic-index substrate of both. This could increase cyclosporine toxicity such as nephrotoxicity.
What this interaction means in plain words
Cyclosporin and Istradefylline 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; Istradefylline belongs to Central Nervous System.
Why it happens
Istradefylline at 40 mg/day weakly inhibits CYP3A4 and P-glycoprotein, reducing cyclosporine metabolism and efflux.
What to do
Monitor cyclosporine trough levels and renal function when istradefylline is started or the dose raised to 40 mg/day, and reduce the cyclosporine dose if levels rise.
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 Istradefylline
Frequently asked questions
Can I take Cyclosporin with Istradefylline?
MediHelp rates the interaction as moderate. Cyclosporin and Istradefylline 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. At higher doses, istradefylline inhibits CYP3A4 and P-glycoprotein and may increase concentrations of cyclosporine, a narrow-therapeutic-index substrate of both. This could increase cyclosporine toxicity such as nephrotoxicity.
How serious is the interaction between Cyclosporin and Istradefylline?
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 cyclosporine trough levels and renal function when istradefylline is started or the dose raised to 40 mg/day, and reduce the cyclosporine dose if levels rise.
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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