Drug interactions
Cyclosporin + Sarilumab
Severity: Moderate
Cyclosporin and Sarilumab: 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
Blocking IL-6 signaling can reverse cytokine-mediated suppression of CYP enzymes, which may lower concentrations of narrow therapeutic index drugs like cyclosporine. This could reduce immunosuppressive effect, particularly around the start or stop of sarilumab.
What this interaction means in plain words
Cyclosporin and Sarilumab 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; Sarilumab belongs to Musculoskeletal.
Why it happens
IL-6 receptor blockade normalizes CYP3A4 expression suppressed by inflammation, increasing cyclosporine metabolism.
What to do
Monitor cyclosporine trough concentrations when starting or stopping sarilumab and adjust the dose accordingly.
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 Sarilumab
Frequently asked questions
Can I take Cyclosporin with Sarilumab?
MediHelp rates the interaction as moderate. Cyclosporin and Sarilumab 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. Blocking IL-6 signaling can reverse cytokine-mediated suppression of CYP enzymes, which may lower concentrations of narrow therapeutic index drugs like cyclosporine. This could reduce immunosuppressive effect, particularly around the start or stop of sarilumab.
How serious is the interaction between Cyclosporin and Sarilumab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporine trough concentrations when starting or stopping sarilumab and adjust the dose accordingly.
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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