CYCLOSPORINE DRUG INTERACTION LIST:
DO NOT take these drugs while you are taking cyclosporine without first notifying our clinic.
Cyclosporine is metabolized in the liver by the 3A4 microsomal CYP450 isozyme. Some of the drugs listed below interact with the liver’s metabolism of cyclosporine, therefore affecting the amount of cyclosporine in your blood. Also, cyclosporine can raise the blood levels of these drugs, thereby increasing the risk of side effects from the drugs. If your doctor prescribes one of these drugs, we ask that you notify us before starting. Some of the drugs on this list below absolutely should not be taken with cyclosporine.
Amphotericin B (Fungizone)
Azapropazone
Atorvastin (Lipitor)—cyclosporine can increase blood levels of atorvastatin
Bromocriptine (Parlodel)
Carbamazepine (Tegretol, Atretol)
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Corticosteroids (mainly methylprednisolone/Medrol)
Danazol (Danocrine)
Diclofenac (Voltaren)
Digoxin (Lanoxin, Lanoxicaps)
Diltiazem (Cardizem, Dilacor)
Dopamine (Intropin)
Erythromycin (E-mycin)
Fluconazole (Diflucan)
Furosemide (Lasix)
Gentamicin (Garamycin, G-myticin)
Heparin
Isoniazid (INH)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lovastatin (Mevacor)—cyclosporine can increase blood levels of lovastatin
Melphalan (Alkeran)
Methylprednisolone (Medrol, Solu-Medrol)—can increase levels of cyclosporin
Metoclopramide (Reglan)
Nicardipine (Cardene)
Norfloxacin (Noroxin, Chibroxin)
NSAIDs (Advil, Motrin, Aleve, Naprosyn, etc.)
Ondansetron (Zofran)
Oral contraceptives (birth-control pills) -- can decrease blood levels of cyclosporine
Orlistat—(Alli, Xenical) decreases absorption of cyclosporin
Phenobarbital (Donnatal)
Rosuvastatin (Crestor)—cyclosporine can increase blood levels of rosuvastatin
Simvastatin (Zocor)- cyclosporine can increase blood levels of simvastatin
Phenytoin (Dilantin)
Rifampin (Rifadin, Rifamate, Rimactane)
Sulfamethoxazole/Trimethroprim (Bactrim, Septra)
Tobramycin (Tobrex, Tobradex)
Vancomycin (Vancocin)
Verapamil (Calan, Verelen)
Note: Most “statin” cholesterol-lowering drugs are metabolized by the same pathway as cyclosporine. If your doctor wants to prescribe a statin drug for high cholesterol, ask the doctor to prescribe pravastatin (Pravachol). Unlike with the other statin drugs, there is no increased risk for experiencing side effects of the statin drugs by taking pravastatin and cyclosporine.
Dietary Restriction: you should AVOID GRAPEFRUIT JUICE, because this can increase cyclosporine levels. We also recommend that you do not take non-prescription herbal supplements, such as St. John’s Wort, because this can decrease cyclosporine levels.
TACROLIMUS DRUG INTERACTION LIST
DO NOT take these drugs while you are taking tacrolimus without first notifying our clinic.
Tacrolimus is metabolized (broken down) in the liver by the 3A4 microsomal CYP450 isozyme system. Some of the drugs listed below interact with the liver’s metabolism of tacrolimus, therefore affecting the amount of tacrolimus in the blood. Also, tacrolimus will affect the blood levels of some of these drugs listed below, thereby increasing the risk of side effects from the drugs. If your doctor prescribes one of these drugs, we ask that you notify us before starting. Some of these drugs listed below absolutely should not be taken with cyclosporine.
Amphotericin B (Fungizone)
Azapropazone
Atorvastin (Lipitor)—tacrolimus can increase blood levels of atorvastatin
Bromocriptine (Parlodel)
Carbamazepine (Tegretol, Atretol)
Cimetidine (Tagamet)
Clarithromycin (Biaxin)
Corticosteroids (mainly methylprednisolone/Medrol)
Danazol (Danocrine)
Diclofenac (Voltaren)
Digoxin (Lanoxin, Lanoxicaps)
Diltiazem (Cardizem, Dilacor)
Dopamine (Intropin)
Erythromycin (E-mycin)
Fluconazole (Diflucan)
Furosemide (Lasix)
Gentamicin (Garamycin)
Heparin
Isoniazid (INH)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Lovastatin (Mevacor)—tacrolimus can increase blood levels of lovastatin
Melphalan (Alkeran)
Metoclopramide (Reglan)
Nicardipine (Cardene)
Norfloxacin (Noroxin, Chibroxin)
NSAIDs (Advil, Motrin, Aleve, Naprosyn, etc.)
Ondansetron (Zofran)
Oral contraceptives (birth-control pills) -- can decrease blood levels of tacrolimus
Phenobarbital (Donnatal)
Rosuvastatin (Crestor)—cyclosporine can increase blood levels of rosuvastatin
Simvastatin (Zocor)- cyclosporine can increase blood levels of simvastatin
Phenytoin (Dilantin)
Rifampin (Rifadin, Rifamate, Rimactane)
Sulfamethoxazole/Trimethroprim (Bactrim, Septra)
Tobramycin (Tobrex, Tobradex)
Vancomycin (Vancocin)
Verapamil (Calan, Verelen)
Note: Most “statin” cholesterol-lowering drugs are metabolized by the same pathway as tacrolimus. If your doctor wants to prescribe a statin drug for high cholesterol, ask the doctor to prescribe pravastatin (Pravachol). Unlike with the other statin drugs, there is no increased risk for experiencing side effects of the statin drugs by taking pravastatin and tacrolimus.
Dietary Restriction: you should AVOID GRAPEFRUIT JUICE, because this can increase tacrolimus levels. We also recommend that you do not take non-prescription herbal supplements, such as St. John’s Wort, because this can decrease tacrolimus levels.