Drug interactions
Cyclosporine + Nicardipine
Severity: Major
Cyclosporine and Nicardipine: 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
Nicardipine can raise cyclosporine blood concentrations, increasing the risk of nephrotoxicity, hypertension and other cyclosporine toxicity. Cyclosporine may also increase nicardipine exposure, adding to hypotension and edema. Gingival hyperplasia can be additive.
What this interaction means in plain words
Cyclosporine and Nicardipine 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
Nicardipine inhibits CYP3A4 and P-glycoprotein, reducing cyclosporine clearance, while cyclosporine inhibits nicardipine metabolism through CYP3A4.
What to do
Monitor cyclosporine trough levels and serum creatinine when nicardipine is started, adjusted or stopped, and reduce the cyclosporine dose as needed. Monitor blood pressure for excessive hypotension.
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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Other interactions of Nicardipine
Frequently asked questions
Can I take Cyclosporine with Nicardipine?
MediHelp rates the interaction as major. Cyclosporine and Nicardipine 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. Nicardipine can raise cyclosporine blood concentrations, increasing the risk of nephrotoxicity, hypertension and other cyclosporine toxicity. Cyclosporine may also increase nicardipine exposure, adding to hypotension and edema. Gingival hyperplasia can be additive.
How serious is the interaction between Cyclosporine and Nicardipine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporine trough levels and serum creatinine when nicardipine is started, adjusted or stopped, and reduce the cyclosporine dose as needed. Monitor blood pressure for excessive hypotension.
What other medicines interact with Nicardipine?
MediHelp also lists interactions of Nicardipine with, for example, Amifostine, Amlodipine-olmesartan-hydrochlorothiazide, Betrixaban. The full list is on the Nicardipine page.
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