Cyclosporine contraindications

Contraindications History of hypersensitivity to cyclosporine or polyoxyethylated castor oil... 

Contraindications Concurrent use with cyclosporine (increases the risk of nephrotoxicity), hypersensitivity to HCO-60 polyoxyl 60 hydrogenated castor oil (used in solution for injection)... 

Editors Notes Commonly affects cyclosporine level. May be useful for Candida UTI and esophageal candidiasis. Coadministration of terfenadine or cisapride is contraindicated due to an increased risk of prolonged QT intervals and torsade de pointes. However, both drugs have now been removed from the market. ... 

Sitaxsentan is a potent and selective agent which inhibits ET-1 binding to ETA receptors (IC50 = 1.4 nM), while being essentially inactive at ETB receptors (IC50 = 9.8 pM).23 In the clinic, it was found to have excellent oral bioavailability (70-100%) and a terminal elimination half-life of 10 h, and is administered as a once daily 100 mg dose. It is highly protein bound in plasma (> 99%) and extensively metabolized in the liver to inactive metabolites, predominantly by CYPs 2C9 and 3A4. Excretion is 50 60% renal, with the balance in the feces.25 Sitaxsentan inhibits CYP 2C9, and was observed to increase exposure to warfarin by over twofold. The use of cyclosporine A is also contraindicated, but no interactions were observed with sildenafil.15 Sitaxsentan was well tolerated in trials, with only minor side effects reported. Reversible liver enzyme abnormalities were also observed, but less frequently than with bosentan.15 25... 

Micafungin Topical 0.1% solution 1 drop ql h while awake Side effects include pulmonary edema, blood dyscrasias, hypercalcemia, hepatotoxicity (rare), gastrointestinal symptoms, headache, fever, chills, anemia, eosinophilia, hypokalemia, liver function test elevations, infusion site reactions. Drug interaction with cyclosporine and additional voriconazole. Pregnancy category C lactation safety unknown. Coadministration of caspofungin is contraindicated with multiple antiretrovirals (refer to Table 11-3) Topical not commercially available... 

Topical cyclosporine is safe and well tolerated in most patients, and there are no absolute contraindications to its use. It has not been approved for use in children, and the FDA pregnancy category is C. 

Heart block is a contraindication for the nondihydropyridines. The most common side effects are bradycardia and heart block (for the nondihydropyridines). Peripheral edema and headache are also common. Nondihydropyridines exacerbate bradycardic effects of /S-blockers, and verapamil raises digoxin serum concentrations by 70%. Diltiazem raises cyclosporine serum concentrations. Intravenous calcium salts inhibit the pharmacologic effect of CCBs. Generic formulations or similar products, but not necessarily generic equivalents to the original brand names, are available for verapamil, nifedipine, and diltiazem. 

Cyclosporin suppresses cell-mediated immune reactions and some humoral immunity. It is indicated in the prophylaxis of organ rejection in kidney, liver, and heart allogeneic transplants in conjunction with adrenal corticosteroid therapy treatment of chronic rejection in patients previously treated with other immunosuppressive agents increased tear production in patients whose tear production is presumed to be suppressed because of ocular inflammation associated with keratoconjunctivitis sicca (ophthalmic emulsion). Gengraf, Neorai Used for treatment of severe active rheumatoid arthritis (RA) where disease is not adequately responsive to methotrexare treatment of adult, non-immunocompromised patients with severe, recalcitrant, plaque psoriasis who have failed to respond to a least one systemic therapy or in patients for whom other systemic therapies are contraindicated, or cannot be tolerated. 

Coadministration with rifampin, rifabutin, or ritonavir is contraindicated because of accelerated voriconazole metabolism. Efavirenz and perhaps other normucleoside reverse transcriptase inhibitors (NNRTIs) significantly increase voriconazole metabolism and slow the metabolism of the NNRTI. When given with phenytoin, the voriconazole dose should be doubled. Drugs that significantly accumulate in patients receiving voriconazole include cyclosporine,... 

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