Cyclosporine toxicity

There is an increased risk of cyclosporine toxicity when the drug is administered with acetazolamide. Decreased serum and urine concentrations of primidone occur when the drug is administered with acetazolamide. 

Drug can be given concurrentlywith cyclosporine, which mayenable reduced cyclosporine doses and lower toxicity, or potential cyclosporine substitute in patients developing cyclosporine toxicity... 

The correct answer = D. Ketoconazole is effective against Candida, but it does not react with cyclosporine nor is it cardiotoxic. Ketoconazole inhibits the hepatic cytochrome P-450 enzymes that inactivate cyclosporine. Thus in this instance the patient would be in danger of increased cyclosporine toxicity. Though ketoconazole does cause gynecomastia and decreased libido, this would not be of primary concern. 

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