Drug-Drug Interactions, Adverse Reactions & Contraindications
Cyclosporine can increase plasma concentration of comedications which are substrates of CYP3A4 as it is an inhibitor of CYP3A4. It can also lead to reduced clearance of drugs like sirolimus, aliskiren, HMG CoA reductase inhibitors like statin, digoxin, colchicine, prednisolone, etoposide, etc. It is important that drug-drug interactions are reviewed prior to administering cyclosporine with any other pharmaceutical drugs as higher concentration of cyclosporine can cause nephrotoxicity and hepatotoxicity. Importantly, nephrotoxicity is noted among cardiac transplant patients (38%), liver transplant patients (37%) and renal transplant patients (25%). Moreover, it can also lead to rising levels of BUN (blood urea nitrogen) and creatinine. Cyclosporine is contraindicated among patients suffering from hypersensitivity to cyclosporine and polyoxyethylated castor oil [24, 28].