Drug interactions
Cyclosporin + Phenobarbital
Severity: Major
Cyclosporin and Phenobarbital: 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
Phenobarbital induces CYP3A4 and P-glycoprotein, which lowers cyclosporine exposure. Reduced levels may cause rejection or loss of immunosuppressive control.
What this interaction means in plain words
Cyclosporin and Phenobarbital 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.
Why it happens
Enzyme induction of CYP3A4 and P-glycoprotein by phenobarbital increases cyclosporine clearance.
What to do
Monitor cyclosporine trough levels closely and raise the dose as required, with dose reduction after phenobarbital is withdrawn. Consider a non-inducing anticonvulsant if feasible.
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
Frequently asked questions
Can I take Cyclosporin with Phenobarbital?
MediHelp rates the interaction as major. Cyclosporin and Phenobarbital 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. Phenobarbital induces CYP3A4 and P-glycoprotein, which lowers cyclosporine exposure. Reduced levels may cause rejection or loss of immunosuppressive control.
How serious is the interaction between Cyclosporin and Phenobarbital?
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 cyclosporine trough levels closely and raise the dose as required, with dose reduction after phenobarbital is withdrawn. Consider a non-inducing anticonvulsant if feasible.
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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