Major
Ciclosporin × Voriconazole
Immunosuppressants. Calcineurin inhibitors×Triazole derivatives, systemic antifungals
Mechanism
Voriconazole inhibits CYP3A4. Cyclosporine rises 1.7-fold.
Symptoms
Nephrotoxicity.
Management
Halve cyclosporine dose.
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.
Sources
- FDA: Vfend (voriconazole) prescribing information – CYP3A4 inhibitor, statin/immunosuppressant interactions (2020)– FDA Vfend label, Drug Interactions §7 – tacrolimus, cyclosporine, sirolimus, statins
- EMA: Vfend (voriconazole) Summary of Product Characteristics, Section 4.3 (2024)