Drug interactions
Cyclosporin + Metronidazole
Severity: Moderate
Cyclosporin and Metronidazole: 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
Metronidazole has been reported to raise cyclosporine blood concentrations, sometimes with a rise in serum creatinine. Elevated cyclosporine exposure can cause nephrotoxicity, neurotoxicity and hypertension.
What this interaction means in plain words
Cyclosporin and Metronidazole 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; Metronidazole belongs to Anti Parasitic.
Why it happens
Probable inhibition of CYP3A4-mediated cyclosporine metabolism by metronidazole, supported mainly by case reports and limited pharmacokinetic data.
What to do
Measure cyclosporine trough concentrations when metronidazole is started or stopped and adjust the cyclosporine dose accordingly. Monitor serum creatinine during the combination.
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 Metronidazole
- Ethanol + Metronidazole Contraindicated
- Metronidazole + Pimozide Contraindicated
- Amiodarone + Metronidazole Major
- Disulfiram + Metronidazole Major
- Ergotamine + Metronidazole Major
- Lomitapide + Metronidazole Major
Frequently asked questions
Can I take Cyclosporin with Metronidazole?
MediHelp rates the interaction as moderate. Cyclosporin and Metronidazole 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. Metronidazole has been reported to raise cyclosporine blood concentrations, sometimes with a rise in serum creatinine. Elevated cyclosporine exposure can cause nephrotoxicity, neurotoxicity and hypertension.
How serious is the interaction between Cyclosporin and Metronidazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Measure cyclosporine trough concentrations when metronidazole is started or stopped and adjust the cyclosporine dose accordingly. Monitor serum creatinine during the combination.
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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