Major
Ciclosporin × Rifampicin
Immunosuppressants. Calcineurin inhibitors×Antituberculous antibiotic
Mechanism
Strong CYP3A4 + P-gp inducer. Cyclosporine falls 70% – rejection risk.
Symptoms
Rejection signs within 1-2 weeks.
Management
Increase cyclosporine 3-5 fold with level monitoring. Alternative – rifabutin (weaker).
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.