Drug interactions
Cyclosporin + Rifaximin
Severity: Moderate
Cyclosporin and Rifaximin: 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
Cyclosporine markedly increases systemic absorption of rifaximin, which is normally minimally absorbed. In patients with intact gut barrier this has been very large, and the consequences of such exposure are not well defined.
What this interaction means in plain words
Cyclosporin and Rifaximin 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; Rifaximin belongs to Anti Bacterial.
Why it happens
Cyclosporine inhibits P-glycoprotein, which limits rifaximin absorption, greatly increasing systemic rifaximin levels.
What to do
Avoid combining where possible, particularly in patients with severe hepatic impairment. If used, monitor for adverse effects of rifaximin and for changes in cyclosporine levels.
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 Rifaximin
- Cholera vaccine + Rifaximin Major
- Microbiota + Rifaximin Major
- Amiodarone + Rifaximin Moderate
- Bcg intravesical live + Rifaximin Moderate
- Cyclosporine + Rifaximin Moderate
- Dronedarone + Rifaximin Moderate
Frequently asked questions
Can I take Cyclosporin with Rifaximin?
MediHelp rates the interaction as moderate. Cyclosporin and Rifaximin 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. Cyclosporine markedly increases systemic absorption of rifaximin, which is normally minimally absorbed. In patients with intact gut barrier this has been very large, and the consequences of such exposure are not well defined.
How serious is the interaction between Cyclosporin and Rifaximin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining where possible, particularly in patients with severe hepatic impairment. If used, monitor for adverse effects of rifaximin and for changes in cyclosporine levels.
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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