cyclosporine and Fk506 Interactions

Interactions between cyclosporine(cycloSPORINE) and Fk506 (tacrolimus)

cycloSPORINE and tacrolimus (Major Drug-Drug)

GENERALLY AVOID: Coadministration of tacrolimus and cyclosporine may increase the risk and severity of nephrotoxicity due to additive effects on the kidney. Clinical experience indicates that the combination is associated with increased renal toxicity as evidenced by increased serum creatinine and decreased glomerular filtration rate. In vitro and animal data also suggest that tacrolimus may inhibit the intestinal first-pass metabolism of cyclosporine via CYP450 3A4, resulting in significantly increased bioavailability of the latter.

MANAGEMENT: To avoid undue nephrotoxicity, tacrolimus and cyclosporine should not be used simultaneously. Tacrolimus or cyclosporine should be discontinued for at least 24 hours prior to initiating the other. In the presence of elevated tacrolimus or cyclosporine concentrations, dosing with the other drug usually should be further delayed.