CICLOSPORIN (CYCLOSPORINE) AND QUINOLONES

Ciclosporin serum levels are normally unchanged by the use of ciprofloxacin, but increased serum levels and nephrotoxicity may occur in a small number of patients. One study, and two case reports describe rises in ciclosporin levels in patients given norfloxacin, but another study found no change. Similar results have been found with levofloxacin.
Increased monitoring of ciclosporin levels and effects would seem prudent in patients given ciprofloxacin, levofloxacin or norfloxacin, although note that evidence for an adverse interaction is limited. There seem to be no reports of problems with enoxacin, ofloxacin, pefloxacin or trovafloxacin.
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