Drug interactions
Cyclosporin + Nirmatrelvir
Severity: Major
Cyclosporin and Nirmatrelvir: 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
Nirmatrelvir is a CYP3A inhibitor and may raise cyclosporine concentrations. This can cause nephrotoxicity and neurotoxicity in transplant recipients.
What this interaction means in plain words
Cyclosporin and Nirmatrelvir 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; Nirmatrelvir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4-mediated cyclosporine metabolism.
What to do
Avoid if possible. If unavoidable, monitor cyclosporine trough levels and renal function and temporarily reduce or hold cyclosporine doses.
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 Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Cyclosporin with Nirmatrelvir?
MediHelp rates the interaction as major. Cyclosporin and Nirmatrelvir 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. Nirmatrelvir is a CYP3A inhibitor and may raise cyclosporine concentrations. This can cause nephrotoxicity and neurotoxicity in transplant recipients.
How serious is the interaction between Cyclosporin and Nirmatrelvir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible. If unavoidable, monitor cyclosporine trough levels and renal function and temporarily reduce or hold cyclosporine doses.
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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