Drug interactions
Cyclosporin + Ritonavir
Severity: Major
Cyclosporin and Ritonavir: 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
Ritonavir is a strong CYP3A4 and P-glycoprotein inhibitor and can greatly increase cyclosporine concentrations. This raises the risk of nephrotoxicity, hypertension and neurotoxicity.
What this interaction means in plain words
Cyclosporin and Ritonavir 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; Ritonavir belongs to Anti Virals.
Why it happens
Inhibition of CYP3A4 metabolism and P-glycoprotein efflux of cyclosporine.
What to do
Reduce the cyclosporine dose substantially and monitor trough levels and renal function closely when starting or stopping ritonavir.
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
Other interactions of Ritonavir
- Alfuzosin + Ritonavir Contraindicated
- Amiodarone + Ritonavir Contraindicated
- Avanafil + Ritonavir Contraindicated
- Colchicine + Ritonavir Contraindicated
- Dronedarone + Ritonavir Contraindicated
- Eletriptan + Ritonavir Contraindicated
Frequently asked questions
Can I take Cyclosporin with Ritonavir?
MediHelp rates the interaction as major. Cyclosporin and Ritonavir 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. Ritonavir is a strong CYP3A4 and P-glycoprotein inhibitor and can greatly increase cyclosporine concentrations. This raises the risk of nephrotoxicity, hypertension and neurotoxicity.
How serious is the interaction between Cyclosporin and Ritonavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the cyclosporine dose substantially and monitor trough levels and renal function closely when starting or stopping ritonavir.
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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