Metoclopramide Ciclosporin

Ciclosporin Metoclopramide increases the rate of absorption and serum levels of ciclosporin - monitor ciclosporin levels closely. 

It has been suggested that metoclopramide increases the systemic availability of ciclosporin (SED-11, 783) (20). 

Metoclopramide moderately increases the absorption of ciclosporin and raises its blood levels. 

When 14 kidney transplant patients were given metoelopramide their peak ciclosporin blood levels were ineieased by 46%, from 388 to 567 nanograms/mL and the ciclosporin AUC was increased by 22%. The dosage of metoclopramide was 10 mg by mouth 30 minutes before, 5 mg with, and 5 mg 30 minutes after the morning dose of ciclosporin. Ciclosporin is largely absorbed by the small intestine so the likely mechanism for this interaction is increased absorption of ciclosporin because metoclopramide hastens gastric emptying. The clinical importance of this interaction is uncertain. Concurrent use should be well monitored to ensure that any increase in ciclosporin peak levels does not increase adverse effects. Note that the increase in the AUC of ciclosporin is only modest. 

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