Drug interactions
Cyclosporin + Itraconazole
Severity: Major
Cyclosporin and Itraconazole: 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
Itraconazole substantially raises cyclosporine concentrations, which can lead to nephrotoxicity, hypertension and neurotoxicity. The effect is well documented and may need a large cyclosporine dose reduction.
What this interaction means in plain words
Cyclosporin and Itraconazole 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; Itraconazole belongs to Anti Fungals.
Why it happens
Itraconazole inhibits CYP3A4 and P-glycoprotein, reducing cyclosporine clearance.
What to do
Reduce the cyclosporine dose when starting itraconazole and monitor trough levels and serum creatinine frequently. Readjust the dose upward when itraconazole is stopped.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Cyclosporin with Itraconazole?
MediHelp rates the interaction as major. Cyclosporin and Itraconazole 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. Itraconazole substantially raises cyclosporine concentrations, which can lead to nephrotoxicity, hypertension and neurotoxicity. The effect is well documented and may need a large cyclosporine dose reduction.
How serious is the interaction between Cyclosporin and Itraconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the cyclosporine dose when starting itraconazole and monitor trough levels and serum creatinine frequently. Readjust the dose upward when itraconazole is stopped.
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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