Ranitidine Ciclosporin

The available data on a possible interaction between histamine H2 receptor antagonists and ciclosporin are inconclusive. Whereas neither cimetidine nor ranitidine significantly altered ciclosporin pharmacokinetics, there was an increase in serum creatinine concentration in patients taking both ciclosporin and cimetidine, but not ranitidine. The clinical significance of this interaction is probably limited, and it has been attributed to competition of cimetidine with creatinine for tubular secretion (251). 

One report (see Cimetidine above), where the eifeets of cimetidine and ranitidine were examined together, suggests that ranitidine raises creatinine levels in patients taking ciclosporin, without affecting ciclosporin levels. Similarly, several other reports say that ranitidine does not alter ciclosporin blood levels. " One also notes that ranitidine does not alter creatinine levels and inulin clearance. ... 

A report describes thrombocytopenia in a man taking ciclosporin after a kidney transplant who was given ranitidine. Another patient experienced hepatotoxicity while taking ciclosporin with ranitidine. ... 

Information about the possible interactions of ciclosporin and cimetidine, famotidine or ranitidine is inconsistent, but there appear to be very few reports of confirmed toxicity. Moreover the reported increases in serum creatinine levels seen with the H2-receptor antagonists may not be a reflection of increased nephrotoxicity (see Mechanism )- Thus there is little to suggest that concurrent use should be avoided, but good initial monitoring is advisable. 

Zazgomik J, Schindler J, Gremmel F, Balcke P, Kopsa H, Derfler K, Minar E. Ranitidine does not influence the blood ciclosporin levels in ren transplant patients (RTP). Kidtey Int... 

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