Drug interactions
Cyclosporin + Roxithromycin
Severity: Moderate
Cyclosporin and Roxithromycin: 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
Roxithromycin is a macrolide with weaker CYP3A4 inhibition than erythromycin, but it can still increase cyclosporine concentrations, with a risk of nephrotoxicity and neurotoxicity. The interaction is therefore mainly relevant to cyclosporine levels.
What this interaction means in plain words
Cyclosporin and Roxithromycin 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; Roxithromycin belongs to Anti Bacterial.
Why it happens
Roxithromycin inhibits CYP3A4 and P-glycoprotein, reducing cyclosporine clearance.
What to do
Check cyclosporine trough levels and creatinine within a few days of starting roxithromycin, and adjust the cyclosporine dose accordingly. Consider an alternative antibiotic such as azithromycin if appropriate.
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 Roxithromycin
- Digoxin + Roxithromycin Major
- Argatroban + Roxithromycin Moderate
- Roxithromycin + Tacrolimus Moderate
- Ampicillin-sulbactam + Roxithromycin Minor
- Ampicillin + Roxithromycin Minor
- Balsalazide + Roxithromycin Minor
Frequently asked questions
Can I take Cyclosporin with Roxithromycin?
MediHelp rates the interaction as moderate. Cyclosporin and Roxithromycin 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. Roxithromycin is a macrolide with weaker CYP3A4 inhibition than erythromycin, but it can still increase cyclosporine concentrations, with a risk of nephrotoxicity and neurotoxicity. The interaction is therefore mainly relevant to cyclosporine levels.
How serious is the interaction between Cyclosporin and Roxithromycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check cyclosporine trough levels and creatinine within a few days of starting roxithromycin, and adjust the cyclosporine dose accordingly. Consider an alternative antibiotic such as azithromycin if appropriate.
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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