Drug interactions
Cyclosporin + Voriconazole
Severity: Major
Cyclosporin and Voriconazole: major interaction.
Last updated Sources: US FDA label
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
Voriconazole substantially increases cyclosporine concentrations, which can cause nephrotoxicity, hypertension and neurotoxicity. The effect is reversed when voriconazole is stopped.
What this interaction means in plain words
Cyclosporin and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Voriconazole inhibits CYP3A4, reducing cyclosporine metabolism.
What to do
When starting voriconazole, reduce the cyclosporine dose by about half and monitor trough levels and creatinine closely. Readjust the dose upward when voriconazole is discontinued.
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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References
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Cyclosporin with Voriconazole?
MediHelp rates the interaction as major. Cyclosporin and Voriconazole 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. Voriconazole substantially increases cyclosporine concentrations, which can cause nephrotoxicity, hypertension and neurotoxicity. The effect is reversed when voriconazole is stopped.
How serious is the interaction between Cyclosporin and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: When starting voriconazole, reduce the cyclosporine dose by about half and monitor trough levels and creatinine closely. Readjust the dose upward when voriconazole is discontinued.
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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