Moderate
Ciclosporin × Paracetamol
Immunosuppressants. Calcineurin inhibitors×Anilides. Analgesics and antipyretics
Mechanism
Paracetamol does not interact significantly with ciclosporin in short courses. On long-term high-dose use (over 3 g/day for more than 7 days), mild hepatocyte suppression may slightly amplify ciclosporin hepatotoxicity.
Symptoms
Fatigue, nausea, jaundice, elevated liver enzymes. Symptoms with long-term therapy are rare.
Management
Paracetamol remains the analgesic and antipyretic of choice in transplant patients. For chronic need, cap at 2 g/day. Check ALT, AST, GGT monthly. If enzymes rise 2–3-fold above the upper limit, stop paracetamol temporarily.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.