CALCIUM-CHANNEL BLOCKERS AND CICLOSPORIN (CYCLOSPORINE) - OTHER CALCIUM-CHANNEL BLOCKERS

Diltiazem, nicardipine and verapamil markedly raise serum ciclosporin levels but also appear to possess kidney protective effects. Amlodipine has modestly increased ciclosporin levels in some studies, but not in others, and it may also have kidney protective properties. A single case describes elevated ciclosporin levels caused by nisoldipine. Nifedipine normally appears not to interact, but rises and falls in ciclosporin levels have been seen in a few patients.
Ciclosporin levels should be well monitored (especially with diltiazem, nicardipine and verapamil) and dosage reductions made as necessary. With diltiazem and verapamil the ciclosporin dosage can apparently be reduced by about 25 to 50% and even greater reductions may be necessary with nicardipine.
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