Potassium-sparing diuretics Ciclosporin

POTASSIUM-SPARING DIURETICS CICLOSPORIN t risk of hyperkalaemia Additive effect >- For signs and symptoms of hyperkalaemia, see Clinical Features of Some Adverse Drug Interactions, Hyperkalaemia... 

Isolated cases of nephrotoxicity have been described when patients taking ciclosporin were given either amiloride with hydrochlorothiazide, metolazone, or mannitol. Furosemide can possibly protect the kidney against ciclosporin damage. The concurrent use of ciclosporin with thiazides, but not loop diuretics, may increase serum magnesium levels. The concurrent use of ciclosporin with potassium-sparing diuretics may cause hyperkalaemia. 

Ciclosporin alone can cause hyperkalaemia, especially if renal function is impaired. Because of this, the US manufacturers suggest that ciclosporin should not be used with potassium-sparing diuretics, whereas the UK manufacturers suggest that caution is required with combined use, with close control of potassium levels. ... 

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