Drug interactions
Cyclosporine + Erythromycin
Severity: Major
Cyclosporine and Erythromycin: 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
Erythromycin raises cyclosporine concentrations and can cause nephrotoxicity, neurotoxicity and hypertension. Cyclosporine may also increase erythromycin levels.
What this interaction means in plain words
Cyclosporine and Erythromycin 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.
Why it happens
Inhibition of CYP3A4 and P-glycoprotein by erythromycin reducing cyclosporine clearance.
What to do
Prefer an alternative antibiotic such as azithromycin. If used together, measure cyclosporine trough levels and creatinine closely and reduce the dose as needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cyclosporine and Erythromycin, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Erythromycin
- Conivaptan + Erythromycin Contraindicated
- Dihydroergotamine intranasal + Erythromycin Contraindicated
- Dihydroergotamine + Erythromycin Contraindicated
- Domperidone + Erythromycin Contraindicated
- Dronedarone + Erythromycin Contraindicated
- Droperidol + Erythromycin Contraindicated
Frequently asked questions
Can I take Cyclosporine with Erythromycin?
MediHelp rates the interaction as major. Cyclosporine and Erythromycin 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. Erythromycin raises cyclosporine concentrations and can cause nephrotoxicity, neurotoxicity and hypertension. Cyclosporine may also increase erythromycin levels.
How serious is the interaction between Cyclosporine and Erythromycin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative antibiotic such as azithromycin. If used together, measure cyclosporine trough levels and creatinine closely and reduce the dose as needed.
What other medicines interact with Erythromycin?
MediHelp also lists interactions of Erythromycin with, for example, Conivaptan, Dihydroergotamine intranasal, Dihydroergotamine. The full list is on the Erythromycin 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.
