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Drug interactions

Cyclosporine + Doxorubicin

Severity: Major

Cyclosporine and Doxorubicin: 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

Cyclosporine inhibits P-gp and CYP3A4 and can raise doxorubicin exposure, with increased myelosuppression, mucositis and cardiotoxicity. Prolonged neutropenia and severe toxicity have been reported with the combination.

What this interaction means in plain words

Cyclosporine and Doxorubicin 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.

Evidence level: Moderate

Why it happens

Cyclosporine inhibits P-glycoprotein and CYP3A4, reducing doxorubicin clearance.

What to do

Avoid if possible; if combined, consider reducing the doxorubicin dose and monitor blood counts and cardiac function closely.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Cyclosporine with Doxorubicin?

MediHelp rates the interaction as major. Cyclosporine and Doxorubicin 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. Cyclosporine inhibits P-gp and CYP3A4 and can raise doxorubicin exposure, with increased myelosuppression, mucositis and cardiotoxicity. Prolonged neutropenia and severe toxicity have been reported with the combination.

How serious is the interaction between Cyclosporine and Doxorubicin?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible; if combined, consider reducing the doxorubicin dose and monitor blood counts and cardiac function closely.

What other medicines interact with Doxorubicin?

MediHelp also lists interactions of Doxorubicin with, for example, Adenovirus types 4 and 7 live, Belatacept, Cobicistat. The full list is on the Doxorubicin page.

Full monographs, dosing and an interaction checker in the MediHelp app

Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.

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