Critical
Ciclosporin × Rosuvastatin
Immunosuppressants. Calcineurin inhibitors×HMG-CoA reductase inhibitors (statins)
Mechanism
Cyclosporine inhibits OATP1B1 – rosuvastatin hepatic uptake falls, plasma concentration rises 7-fold. FDA Crestor Section 7 contraindication.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
Combination contraindicated. Alternative – pravastatin 20 mg (minimal risk).
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.