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].