Cyclosporine
Comprehensive clinical interaction and dietary monograph for Cyclosporine (Cyclosporine).
Kitchen Food, Drink & Dietary Conflicts
Biochemical interactions with common foods, beverages & cooking ingredientsAvoid drinking grapefruit juice or eating grapefruit while taking cyclosporine or cyclosporine (modified). Your doctor may tell you to limit the amount of potassium in your diet. Follow these instructions carefully. Talk to your doctor about the amount of potassium-rich foods such as bananas, prunes, raisins, and orange juice you may have in your diet. Many salt substitutes contain potassium, so talk to your doctor about using them during your treatment.
Grapefruit / Pomelo (Citrus paradisi / Citrus maxima)
Destroys enterocyte CYP3A4 enzymes, collapsing first-pass drug metabolism and causing up to 12-fold spikes in bioavailability for oral CYP3A4 substrates (statins, calcium channel blockers, immunosuppressants, PDE5 inhibitors).
Potassium-Enriched Salt Substitutes (Low-Sodium Table Salt)
Provides 500-1400 mg potassium per 1/4 teaspoon. When renal potassium excretion is suppressed by ACE inhibitors, ARBs, or aldosterone antagonists (spironolactone), acute severe hyperkalemia (>6.5 mEq/L) can trigger sudden flaccid paralysis and fatal ventricular fibrillation.
Dairy Milk, Yogurt & Calcium-Enriched Foods
Divalent calcium binds fluoroquinolone (ciprofloxacin) and tetracycline (doxycycline) antibiotics into unabsorbable ring complexes, reducing systemic antibacterial coverage by up to 90% and causing therapy failure.
Fresh Orange Juice & Apple Juice (OATP Influx Blockers)
Unlike CYP3A4 inhibitors that increase drug levels, fruit juice bioflavonoids block the enterocyte OATP influx pumps, plummeting absorption of oral fexofenadine (Allegra), ciprofloxacin, and atenolol by 30-70%.
Alcoholic Beverages (Beer, Wine, Spirits)
Multiplies respiratory depression and profound sedation with opioids and sedatives; blocks hepatic lactate uptake with metformin (lactic acidosis); triggers acute disulfiram-like vomiting and tachycardia with metronidazole; and accelerates dose-dumping in extended-release capsules.
Prescription & OTC Drug Interactions (DDI)
Documented pharmacological conflicts & contraindicated co-prescriptionsNSAIDs (Ibuprofen, Naproxen) & Non-Cardioprotective Analgesics
Mechanism: Inhibition of renal vasodilatory prostaglandins (PGI2, PGE2) causes afferent arteriolar vasoconstriction, blunts blood pressure control, and increases risk of acute kidney injury (AKI).
Dietary Supplements, Herbs & Minerals (DNI)
Interactions with over-the-counter vitamins, minerals, and herbal preparationsSt. John's Wort (Hypericum perforatum)
Hyperforin potently activates the Pregnane X Receptor (PXR), inducing hepatic CYP enzymes and intestinal P-gp pumps. This accelerates medication clearance and precipitates therapeutic failure.
Chronotherapy & Meal Administration Protocols
Optimal absorption, meal-timing rules & GI tolerability protocolsCyclosporine (modified) oral solution may be mixed with room temperature (77 °F [25 °C]) orange juice or apple juice but should not be mixed with milk.
Rationale: Promotes optimal mucosal absorption and consistent therapeutic plasma levels.
Cyclosporine oral solution may be mixed with milk, chocolate milk, or orange juice.
Rationale: Promotes optimal mucosal absorption and consistent therapeutic plasma levels.
Frequently Researched Drug-Substance Combinations
Explore pairwise interaction dossiers and laboratory safety analysesCyclosporine and Grapefruit
Pairwise Clinical Analysis & Safety RatingCyclosporine and Grapefruit-juice
Pairwise Clinical Analysis & Safety RatingCyclosporine and Potassium
Pairwise Clinical Analysis & Safety RatingCyclosporine and Salt-substitute
Pairwise Clinical Analysis & Safety RatingTaking Cyclosporine alongside daily coffee, supplements, or other medications?
Add all your daily medications, foods (Dairy, Spinach, Coffee, Grapefruit), and botanicals (Ashwagandha, Curcumin, Melatonin) into the SafeStack interactive engine to run full multi-way synergy collision analysis in real time.
Data on this clinical monograph is compiled from the U.S. National Library of Medicine (MedlinePlus), openFDA Structured Product Labeling (SPL Section 7 Drug Interactions), the NIH Office of Dietary Supplements (ODS), and Krause and Mahan's Food & Nutrition Care Process.