Drug interactions
Cyclosporin + Lopinavir
Severity: Major
Cyclosporin and Lopinavir: 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
Lopinavir, given with ritonavir as a booster, inhibits CYP3A4 and can markedly raise cyclosporine blood concentrations. This raises the risk of nephrotoxicity, hypertension and neurotoxicity.
What this interaction means in plain words
Cyclosporin and Lopinavir 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; Lopinavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4 (and P-glycoprotein) by lopinavir/ritonavir reduces cyclosporine metabolism and efflux.
What to do
If coadministration is unavoidable, reduce the cyclosporine dose and monitor whole-blood trough levels and renal function frequently. Re-titrate when the antiretroviral is started or 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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cyclosporin and Lopinavir, 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 7 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 Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Cyclosporin with Lopinavir?
MediHelp rates the interaction as major. Cyclosporin and Lopinavir 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. Lopinavir, given with ritonavir as a booster, inhibits CYP3A4 and can markedly raise cyclosporine blood concentrations. This raises the risk of nephrotoxicity, hypertension and neurotoxicity.
How serious is the interaction between Cyclosporin and Lopinavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: If coadministration is unavoidable, reduce the cyclosporine dose and monitor whole-blood trough levels and renal function frequently. Re-titrate when the antiretroviral is started or 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.
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.
