Drug interactions
Cyclosporin + Rifapentine
Severity: Major
Cyclosporin and Rifapentine: 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
Rifapentine is an inducer of CYP3A4 and can markedly reduce cyclosporine exposure. This may lead to graft rejection or loss of immunosuppressive effect.
What this interaction means in plain words
Cyclosporin and Rifapentine 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; Rifapentine belongs to Anti Bacterial.
Why it happens
Induction of CYP3A4 (and likely P-glycoprotein) increases cyclosporine clearance.
What to do
Monitor cyclosporine trough levels frequently and increase the dose as required, with dose reduction after rifapentine is discontinued. Use an alternative antimycobacterial if possible.
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 Rifapentine
- Ledipasvir-sofosbuvir + Rifapentine Contraindicated
- Lorlatinib + Rifapentine Contraindicated
- Lurasidone + Rifapentine Contraindicated
- Ranolazine + Rifapentine Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir Contraindicated
- Rifapentine + Sofosbuvir-velpatasvir-voxilaprevir Contraindicated
Frequently asked questions
Can I take Cyclosporin with Rifapentine?
MediHelp rates the interaction as major. Cyclosporin and Rifapentine 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. Rifapentine is an inducer of CYP3A4 and can markedly reduce cyclosporine exposure. This may lead to graft rejection or loss of immunosuppressive effect.
How serious is the interaction between Cyclosporin and Rifapentine?
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 frequently and increase the dose as required, with dose reduction after rifapentine is discontinued. Use an alternative antimycobacterial if possible.
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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