transporter. Avoid or Use Alternate Drug. If coadministration unavoidable, separate administration by at least 6 hr before or after administration of P-gp substrates with narrow therapeutic index.ergotamineSerious - Use Alternative (1)cyclosporine will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erlotinibMonitor Closely (2)cyclosporine will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of erlotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.erythromycin baseMonitor Closely (2)erythromycin base will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. cyclosporine will increase the level or effect of erythromycin base by Other (see comment). Use Caution/Monitor. may increase plasma concentrations of organic anion transporter protein substratesSerious - Use Alternative (2)cyclosporine will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. erythromycin base will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin ethylsuccinateMonitor Closely (2)erythromycin ethylsuccinate will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. cyclosporine will increase the level or effect of erythromycin ethylsuccinate by Other (see comment). Use Caution/Monitor. may increase plasma concentrations of organic anion transporter protein substratesSerious - Use Alternative (2)erythromycin ethylsuccinate will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. cyclosporine will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin lactobionateMonitor Closely (2)erythromycin lactobionate will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. cyclosporine will increase the level or effect of erythromycin lactobionate by Other (see comment). Use Caution/Monitor. may increase plasma concentrations of organic anion transporter protein substratesSerious - Use Alternative (2)erythromycin lactobionate will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. cyclosporine will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.erythromycin stearateMonitor Closely (2)erythromycin stearate will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. cyclosporine will increase the level or effect of erythromycin stearate by Other (see comment). Use Caution/Monitor. may increase plasma concentrations of organic anion transporter protein substratesSerious - Use Alternative (2)erythromycin stearate will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. cyclosporine will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.eslicarbazepine acetateMonitor Closely (1)eslicarbazepine acetate will decrease the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.esomeprazoleMonitor Closely (1)cyclosporine, esomeprazole. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: When used for prolonged periods of time PPIs may cause hypomagnesemia and the risk is further increased when used concomitantly with drugs that also have the same effects.estradiolMonitor Closely (2)cyclosporine will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of estradiol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.estradiol vaginalMinor (1)cyclosporine will increase the level or effect of estradiol vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.estrogens conjugated syntheticMonitor Closely (2)cyclosporine will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of estrogens conjugated synthetic by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.estrogens esterifiedMonitor Closely (1)cyclosporine will increase the level or effect of estrogens esterified by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.estropipateMonitor Closely (2)cyclosporine will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of estropipate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.etanerceptSerious - Use Alternative (1)cyclosporine and etanercept both increase immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.ethinylestradiolMonitor Closely (1)ethinylestradiol increases levels of cyclosporine by unknown mechanism. Use Caution/Monitor.ethotoinSerious - Use Alternative (1)ethotoin decreases levels of cyclosporine by increasing metabolism. Avoid or Use Alternate Drug.etodolacMonitor Closely (1)etodolac, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Potential for dangerous interaction. Use with caution and monitor closely.etonogestrelMonitor Closely (1)cyclosporine will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.etoposideMonitor Closely (2)cyclosporine will increase the level or effect of etoposide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.etravirineMonitor Closely (1)etravirine will decrease the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.eucalyptusMinor (1)cyclosporine will increase the level or effect of eucalyptus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.everolimusMonitor Closely (1)cyclosporine will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Everolimus is a CYP3A4 and P-gp substrate. Prescribing information for coadministration with cyclosporine (a CYP3A4 and P-gp strong inhibitor) depends on everolimus indication and brand. Avoid coadministration if used for renal cell carcinoma (Afinitor). If used for kidney transplant immunosuppression (Zortress), reduce cyclosporine dose and use target serum concentration to reduce nephrotoxicity.ezetimibeSerious - Use Alternative (1)cyclosporine, ezetimibe. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Monitor for potential adverse effects of cyclosporine and ezetimibe if coadministered, especially in patients with severe renal impairment.famotidineMonitor Closely (1)famotidine will increase the level or effect of cyclosporine by unknown mechanism. Use Caution/Monitor. Delayed resorption of cyclosporine has been reported when famotidine is coadministered with cyclosporine.fedratinibMonitor Closely (1)fedratinib will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.felodipineMonitor Closely (2)cyclosporine will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. felodipine will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.fenofibrateMonitor Closely (1)fenofibrate increases levels of cyclosporine by unspecified interaction mechanism. Use Caution/Monitor.fenofibrate micronizedMonitor Closely (1)fenofibrate micronized increases levels of cyclosporine by unspecified interaction mechanism. Use Caution/Monitor.fenofibric acidMinor (1)fenofibric acid increases levels of cyclosporine by unspecified interaction mechanism. Minor/Significance Unknown.fenoprofenMonitor Closely (1)fenoprofen, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Potential for dangerous interaction. Use with caution and monitor closely.fentanylSerious - Use Alternative (1)cyclosporine will increase the level or effect of fentanyl by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.fentanyl intranasalSerious - Use Alternative (1)cyclosporine will increase the level or effect of fentanyl intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.fentanyl transdermalSerious - Use Alternative (1)cyclosporine will increase the level or effect of fentanyl transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.fentanyl transmucosalSerious - Use Alternative (1)cyclosporine will increase the level or effect of fentanyl transmucosal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of CYP3A4 inhibitors with fentanyl is necessary, monitor patients for respiratory depression and sedation at frequent intervals and consider fentanyl dose adjustments until stable drug effects are achieved.ferric maltolMonitor Closely (1)ferric maltol, cyclosporine. Either increases levels of the other by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Coadministration of ferric maltol with certain oral medications may decrease the bioavailability of either ferric maltol and some oral drugs. For oral drugs where reductions in bioavailability may cause clinically significant effects on its safety or efficacy, separate administration of ferric maltol from these drugs. Duration of separation may depend on the absorption of the medication concomitantly administered (eg, time to peak concentration, whether the drug is an immediate or extended release product).fesoterodineMonitor Closely (1)cyclosporine will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fexinidazoleSerious - Use Alternative (1)fexinidazole will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.fexofenadineMinor (1)cyclosporine will increase the level or effect of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.finerenoneMonitor Closely (2)cyclosporine will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed. cyclosporine and finerenone both increase serum potassium. Modify Therapy/Monitor Closely. Finerenone dose adjustment based on current serum potassium concentration. Monitor serum potassium and adjust finerenone dose as described in the prescribing information as necessary.fingolimodMonitor Closely (1)cyclosporine increases effects of fingolimod by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Concomitant therapy is expected to increase the risk of immunosuppression. Use caution when switching patients from long-acting therapies with immune effects. .flibanserinContraindicated (1)cyclosporine will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Coadministration of flibanserin with moderate or strong CYP3A4 inhibitors is contraindicated. Severe hypotension or syncope can occur.Monitor Closely (1)flibanserin increases levels of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Increase monitoring of concentrations of drugs transported by P-gp that have a narrow therapeutic index if coadministered with flibanserin.fluconazoleMonitor Closely (1)fluconazole will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fludrocortisoneMonitor Closely (3)cyclosporine will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of fludrocortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. fludrocortisone, cyclosporine. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may increase or decrease cyclosporine concentrations. Also, cyclosporine may increase the plasma concentrations of the corticosteroids. Monitor for changes in cyclosporine concentrations and for toxicities of corticosteroids and/or cyclosporine.flurbiprofenMonitor Closely (1)flurbiprofen, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.fluvastatinSerious - Use Alternative (1)cyclosporine increases toxicity of fluvastatin by Other (see comment). Avoid or Use Alternate Drug. Comment: OATP1B1 inhibitors may increase risk of myopathy. OATP1B1 inhibitors may increase risk of myopathy. Limit fluvastatin to 20 mg BID in patients who are also receiving cyclosporine.fluvoxamineMonitor Closely (1)fluvoxamine will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.fosamprenavirMonitor Closely (2)cyclosporine will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. fosamprenavir will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.fosaprepitantMonitor Closely (2)fosaprepitant will increase the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. cyclosporine will increase the level or effect of fosaprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.foscarnetMonitor Closely (1)cyclosporine and foscarnet both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor.fosphenytoinMonitor Closely (2)fosphenytoin will decrease the level or effect of cyclosporine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. fosphenytoin will decrease the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.fostamatinibMonitor Closely (1)fostamatinib will increase the level or effect of cyclosporine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Concomitant use of fostamatinib may increase concentrations of P-gp substrates. Monitor for toxicities of the P-gp substrate drug that may require dosage reduction when given concurrently with fostamatinib.furosemideMonitor Closely (1)cyclosporine increases toxicity of furosemide by Other (see comment). Use Caution/Monitor. Comment: Concomitant use of cyclosporine and furosemide is associated with increased risk of gouty arthritis secondary to furosemide-induced hyperurecemia and cyclosporine impairment of renal urate excretion.gentamicinMonitor Closely (1)cyclosporine and gentamicin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.glecaprevir/pibrentasvirSerious - Use Alternative (1)cyclosporine will increase the level or effect of glecaprevir/pibrentasvir by decreasing metabolism. Avoid or Use Alternate Drug. Coadministration of cyclosporine (a moderate CYP3A4 inhibitor and P-gp inhibitor) with glecaprevir (CYP3A4 and P-gp substrate)