Bezafibrate significantly increased
serum creatinine and tended to reduce
ciclosporin levels in one study. Deterioration in
renal function has also been reported in 5 patients, 4 of whom had no change in
ciclosporin levels, and one of whom had increased
serum ciclosporin levels. The use of
fenofibrate has also been associated with reduced
renal function and possibly reduced
serum ciclosporin levels. Two studies found no pharmacokinetic interaction between
ciclosporin and
gemfibrozil while a third found
gemfibrozil caused a significant reduction in
ciclosporin levels.
Ciclosporin levels and effects (e.g. on
renal function) should be monitored as a matter of routine, but it may be prudent to increase monitoring if a fibrate is started or stopped. Adjust the dose of
ciclosporin as necessary.