Drug Interactions between cyclosporine and Naprosyn

Grapefruit and grapefruit juice can increase the levels of cycloSPORINE in your body and should generally not be consumed during treatment. High blood levels of cycloSPORINE can lead to increased risk of serious side effects on kidney, liver, and nervous system functions. If you regularly consume grapefruits or grapefruit juice, you should be monitored for side effects and/or changes in cycloSPORINE levels. However, do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. You should also take cycloSPORINE on a consistent schedule with regard to time of day and relation to meals. Let your doctor know if you experience fever, rash, nausea, vomiting, abdominal pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), decreased urination, excessive thirst, swelling, weight gain, dizziness, fatigue, weakness, headache, blurred vision, numbness/burning/tingling in the hand and feet, tremors, or convulsions, as they may be symptoms caused by excessive effects of cycloSPORINE.

Ask your doctor before using naproxen together with ethanol (alcohol). Do not drink alcohol while taking naproxen. Alcohol can increase your risk of stomach bleeding caused by naproxen. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Consumer information for this interaction is not currently available.

MONITOR: Smoking cessation may lead to elevated plasma concentrations and enhanced pharmacologic effects of drugs that are substrates of CYP450 1A2 (and possibly CYP450 1A1) and/or certain drugs with a narrow therapeutic index (e.g., flecainide, pentazocine). One proposed mechanism is related to the loss of CYP450 1A2 and 1A1 induction by polycyclic aromatic hydrocarbons in tobacco smoke; when smoking cessation agents are initiated and smoking stops, the metabolism of certain drugs may decrease leading to increased plasma concentrations. The mechanism by which smoking cessation affects narrow therapeutic index drugs that are not known substrates of CYP450 1A2 or 1A1 is unknown. The clinical significance of this interaction is unknown as clinical data are lacking.

MANAGEMENT: Until more information is available, caution is advisable if smoking cessation agents are used concomitantly with drugs that are substrates of CYP450 1A2 or 1A1 and/or those with a narrow therapeutic range. Patients receiving smoking cessation agents may require periodic dose adjustments and closer clinical and laboratory monitoring of medications that are substrates of CYP450 1A2 or 1A1.