Drug Interactions
There are many medications that can affect the metabolism of other medications. Therefore, it is very important to be aware of this possibility and always check with your transplant team if you begin or discontinue any medication.
Here is a list of the more well known drug interactions that you should be aware of. This list is not meant to be inclusive.
First, always remember to follow these two very important rules:
1. Never take any medicine with grapefruit or grapefruit juice
2. Always take your medicines at the same time every day
Drugs that interact with Azathioprine (Imuran)
Allopurinol (Zyloprim) is a medication for gout and can seriously impact white blood counts when taken with azathioprine (Imuran). Avoid this medicine if at all possible if you are taking azathioprine (Imuran)
Drugs that increase levels of Cyclosporine
- Amiodarone (Cordirone)
- androgensť (ie: testosterone)
- azolesť (itraconazole, ketaconazole, fluconazole, miconazole)
- cimetidine (Tagamet)
- ciprofloxacin (Cipro)
- clarithromycin (Biaxin)
- diltiazem (Cardizem, Cartia, Dilacor, Tiazac)
- erythromycin (E-Mycin, Ery-Tab, Eryc)
- metoclopromide (Reglan)
- metronidazole (Flagyl)
- nefazodone (Serzone)
- nifedipine (Adalat, Procardia)
- oral contraceptives
- sirolimus (Rapamune) (should be taken four hours after a dose of cyclosporine)
- verapamil (Calan, Covera-HS, Isoptin, Verelan)
Drugs that may decrease levels of Cyclosporine
- barbiturates (Butabarbitol, Phenobarbitol, Secobarbitol, Amobarbitol)
- carbamazepine (Carbetrol, Tegretol)
- modafinil (Provigil)
- nafcillin
- phenytoins (Dilantin)
- rifabutin
- rifampin (Rifadin, Rimactane)
- statinsť (Lipitor, Lescol, Mevacor, Pravachol, Zocor)
- terbinafine (Lamisal)
- tolterodine (Detrol)
Drugs that may impact renal function when taken with Cyclosporine
- ACE inhibitors (Captopril, Enalapril, Quinapril, Amlodipine, Lisinopril)
- aminoglycosides (Amikacin, Gentamycin, Tobramycin)
- glyburide
- metformin
- sirolimus (Rapamune ) (should be taken four hours after a dose of cyclosporine)
- sulfa-trimethoprim (Bactrim, Septra)
Drugs that may increase levels of Sirolimus
- azolesť (clotrimazole, fluconazole, itraconazole, miconazole)
- cyclosporine (Sandimmune, Neoral, Sangcya, Gengraf etc.) (should be taken four hours before a dose of sirolimus)
- cisapride
- clarithromycin (Biaxin)
- metaclopromide (Reglan)
- verapamil (Calan, Covera-HS, Isoptin, Verelan)
Drugs that may decrease levels of Sirolimus
- barbiturates (Butabarbitol, Phenobarbitol, Secobarbitol, Amobarbitol)
- carbamazepine (Tegretol)
- phenytoin (Dilantin)
- phenobarbitol
- rifabutin (Mycobutin)
- rifapentine (Priftin)
- St. John's Wort
Drugs that may increase levels of Tacrolimus
- androgensť (i.e., testosterone)
- azolesť (Itraconazole, Ketaconazole, Fluconazole, Miconazole)
- cimetidine (Tagamet)
- cisapride (Propulsid)
- clarithromycin (Biaxin)
- diltiazem (Cardizem, Cartia, Dilacor, Tiazac)
- erythromycin (E-Mycin, Ery-Tab, Eryc)
- metoclopramide (Reglan)
- metronidazole (Flagyl)
- nefazodone (Serzone)
- nifedipine (Adalat, Procardia)
- oral contraceptives
- sirolimus (Rapamune) (should be taken four hours after a dose of tacrolimus)
- verapamil (Calan, Covera-HS, Isoptin, Verelan)
Drugs that may decrease levels of Tacrolimus
- barbiturates (Butabarbitol, Phenobarbitol, Secobarbitol, Amobarbitol)
- carbamazipine (Carbetrol, Tegretol)
- nafcillin
- phenytoins (Dilantin)
- rifabutin
- rifampin (Rifadin, Rimactane)
Drugs that may impact renal function when taken with levels of Tacrolimus
- ACE inhibitors (Captopril, Enalapril, Quinapril, Amlodipine, Lisinopril)
- aminoglycosides (Amikacin, Gentamycin, Tobramycin)
- glyburide
- metformin
- sirolimus (Rapamune) (should be taken four hours after a dose of tacrolimus)
- sulfa-trimethoprim (Bactrim, Septra)