Drug interactions
Cyclosporin + Leflunomide
Severity: Major
Cyclosporin and Leflunomide: 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
Both agents suppress immune function, so concurrent use increases the risk of infection and bone marrow or liver toxicity. Leflunomide has a very long active-metabolite half-life, so effects persist after stopping.
What this interaction means in plain words
Cyclosporin and Leflunomide 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; Leflunomide belongs to Musculoskeletal.
Why it happens
Additive immunosuppression through calcineurin inhibition and inhibition of pyrimidine synthesis by leflunomide's active metabolite.
What to do
Monitor blood counts, liver enzymes and signs of infection regularly. Avoid the combination unless specialist-directed, and consider a leflunomide washout if toxicity occurs.
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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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 Leflunomide
- Bcg vaccine live + Leflunomide Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Leflunomide Contraindicated
- Leflunomide + Measles mumps and rubella vaccine live Contraindicated
- Leflunomide + Measles mumps rubella and varicella vaccine live Contraindicated
- Leflunomide + Measles vaccine Contraindicated
- Leflunomide + Smallpox vaccine live Contraindicated
Frequently asked questions
Can I take Cyclosporin with Leflunomide?
MediHelp rates the interaction as major. Cyclosporin and Leflunomide 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. Both agents suppress immune function, so concurrent use increases the risk of infection and bone marrow or liver toxicity. Leflunomide has a very long active-metabolite half-life, so effects persist after stopping.
How serious is the interaction between Cyclosporin and Leflunomide?
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 blood counts, liver enzymes and signs of infection regularly. Avoid the combination unless specialist-directed, and consider a leflunomide washout if toxicity occurs.
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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