CRITICAL ANALYSIS OF CYCLOSPORINE DRUG-INTERACTIONS

Cyclosporine A is a potent immunosuppressive agent, widely used in organ transplantation, in bone marrow transplantation and in the treatment of some autoimmune diseases. Changes of its absorption, a metabolism mainly processed by the liver and a concentration-related nephrotoxicity lead to the need of a careful drug monitoring, allowing to obtain blood levels that must be low and nevertheless sufficiently efficient. Cyclosporin A may additionnaly yield some numerous drug interactions. Those with potentially serious issue must be mandatory avoided and distinguished from those less severe that only have to be followed up. The strategy differs according to the nature of the interaction (i.e. pharmacokinetic/pharmacodynamic): the posology will have either to be adjusted or the risk/benefit ratio will have to be taken into account to decide any change in the dosage regimen.