Drug interactions
Cyclosporin + Sulfamethoxazole
Severity: Moderate
Cyclosporin and Sulfamethoxazole: 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
Trimethoprim-sulfamethoxazole has been associated with increased serum creatinine and nephrotoxicity in cyclosporine-treated patients, and with reduced cyclosporine levels after intravenous use. Hyperkalemia can also occur when trimethoprim is present.
What this interaction means in plain words
Cyclosporin and Sulfamethoxazole 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.
Why it happens
Additive renal toxicity and possible altered cyclosporine metabolism; trimethoprim also reduces potassium excretion.
What to do
Monitor serum creatinine, potassium and cyclosporine trough concentrations. Adjust cyclosporine dose as needed or consider an alternative antimicrobial.
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
Frequently asked questions
Can I take Cyclosporin with Sulfamethoxazole?
MediHelp rates the interaction as moderate. Cyclosporin and Sulfamethoxazole 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. Trimethoprim-sulfamethoxazole has been associated with increased serum creatinine and nephrotoxicity in cyclosporine-treated patients, and with reduced cyclosporine levels after intravenous use. Hyperkalemia can also occur when trimethoprim is present.
How serious is the interaction between Cyclosporin and Sulfamethoxazole?
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 serum creatinine, potassium and cyclosporine trough concentrations. Adjust cyclosporine dose as needed or consider an alternative antimicrobial.
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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