Three heart transplant patients required
ciclosporin dose reductions of about 15 to 30% when
posaconazole was added. The manufacturers also report cases of
ciclosporin toxicity which resulted in significant adverse effects, including nephrotoxicity and one case of fatal leukoencephalopathy.
The manufacturers suggest that the dose of
ciclosporin should be reduced by about 25% when
posaconazole is started, with careful monitoring of
ciclosporin levels and further dose adjustment as needed.