The concurrent use of
ciclosporin and
corticosteroids is very common, but some evidence suggests that
ciclosporin serum levels are raised by
corticosteroids (2-fold by
methylprednisolone, and by up to 20% with
prednisolone or prednisone).
Ciclosporin can moderately increase corticosteroid levels, which may lead to
symptoms of overdosage (cushingoid
symptoms such as steroid-induced
diabetes, osteonecrosis of the hip joints). Convulsions have also been described during concurrent use.
The combination is commonly used, and the case reports and studies document effects well known to be adverse effects of both drugs. The
clinical importance of this interaction is probably limited, but if abnormal results occur, remember that this drug combination could perhaps be a cause.