If it is impossible to avoid the simultaneous application of drugs cyclosporin and capable of interacting with it must observe the following.
When combined with testosterone cypionate half life the drug cyclosporin possessing nephrotoxic effects, careful monitoring of renal function (in particular, the creatinine concentration in the plasma). If any severe impaired renal function the dose of this drug should be reduced or consider alternative treatment.
There are anecdotal reports about the development of a significant, but reversible renal dysfunction (with corresponding increase in serum creatinine concentration) in patients after transplantation, while the use of cyclosporine with fibric acid derivatives (eg bezafibrate, fenofibrate). Therefore, these patients need to monitor renal function. In the case of severe impaired renal function concomitant use of the above drugs should be discontinued.
Drugs that reduce or increase the bioavailability of cyclosporin: patients who underwent transplantation , it is necessary frequently to determine the concentration of cyclosporine and, if necessary, changing the dose of cyclosporin, especially at the initial stage of concurrent treatment, or during its cancellation. In patients without graft monitoring the concentration of cyclosporin has this significant, since these patients the relationship of blood concentration and clinical effects proved testosterone cypionate half life quite clearly. When combined appointment of cyclosporine, and medications that increase its concentration, frequent monitoring of renal function and the monitoring of side effects of cyclosporine are more important than the determination of plasma concentrations of cyclosporine.
In patients with gingival hyperplasia during therapy with cyclosporine should avoid concomitant use of nifedipine.
Nonsteroidal anti-inflammatory drugs with a pronounced effect of “first pass” through the liver (for example, diclofenac) should be administered at lower doses than in patients not receiving cyclosporin.
At simultaneous application with cyclosporine digoxin, colchicine or HMG-CoA reductase inhibitors (statins), careful clinical surveillance for early detection of toxic effects of these drugs and to address the issue of reducing the dose or withdrawal of treatment.
There have been reports that grapefruit juice increases the bioavailability of cyclosporin.
Sandimmun should be used only by physicians experienced in immunosuppressive therapy and have the ability to ensure adequate monitoring of patients, including regular full physical examination, measurement of blood pressure and control the concentration of creatinine in serum. Monitoring of patients after transplantation and receiving the drug should only be carried out in facilities which are provided by trained medical personnel and adequate laboratory resources.
It should be borne in mind that the application of cyclosporin as well as other immunosuppressants, increased risk of lymphomas and other malignant neoplasms, most of the skin. Increased risk of this complication is related to a greater degree with the degree and duration of immunosuppression than by using a specific drug. Therefore, caution should be exercised when using combination regimens of immunosuppressive therapy, bearing in mind the likelihood of developing lymphoproliferative disorders and solid organ tumors, sometimes resulting in fatal outcomes.
Given the potential risk of malignant skin tumors, patients treated with cyclosporine, you should avoid over-exposure to direct sunlight, ultraviolet testosterone cypionate half liferadiation, PUVA therapy (photochemotherapy).