Selected Immunosuppressants/NSAIDs; Salicylates Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both your immunosuppressant and NSAIDs can affect your kidneys.

What might happen:

You may experience a decrease in kidney function.

What you should do about this interaction:

Let your healthcare professional (e.g. doctor or pharmacist) know that you are taking these medicines together. If you experience mental confusion, blurred vision, fever, sore throat, stomach pain, hearing problems, chest pain, changes in the amount of urine, fatigue, or unusual bleeding or bruising, contact your doctor. It may be necessary to change you to a different medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

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  • 2.Harris KP, Jenkins D, Walls J. Nonsteroidal antiinflammatory drugs and cyclosporine. A potentially serious adverse interaction. Transplantation 1988 Oct;46(4):598-9.
  • 3.Mueller EA, Kovarik JM, Koelle EU, Merdjan H, Johnston A, Hitzenberger G. Pharmacokinetics of cyclosporine and multiple-dose diclofenac during coadministration. J Clin Pharmacol 1993 Oct;33(10):936-43.
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  • 6.Ludwin D, Bennett KJ, Grace EM, Buchanan WW, Bensen W, Bombardier C, Tugwell PX. Nephrotoxicity in patients with rheumatoid arthritis treated with cyclosporine. Transplant Proc 1988 Jun;20(3 Suppl 4):367-70.
  • 7.Altman RD, Perez GO, Sfakianakis GN. Interaction of cyclosporine A and nonsteroidal anti-inflammatory drugs on renal function in patients with rheumatoid arthritis. Am J Med 1992 Oct;93(4):396-402.
  • 8.Prograf (tacrolimus) UK summary of product characteristics. Fujisawa Limited November 14, 2002.
  • 9.Prograf (tacrolimus) Canadian prescribing information. Astellas April 27, 2011.
  • 10.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. September, 2004.
  • 11.Rapamune (sirolimus) US prescribing information. Wyeth Pharmaceuticals Aug, 2022.
  • 12.Delzer LM, Golightly LK, Kiser TH, Biggins SW, Lewis VJ, Kim II. Calcineurin Inhibitor and Nonsteroidal Anti-inflammatory Drug Interaction: Implications of Changes in Renal Function Associated With Concurrent Use. J Clin Pharmacol 2018 Nov;58(11):1443-1451.
  • 13.Afinitor (everolimus) US prescribing information. Novartaris Pharmaceuticals Corporation February, 2020.
  • 14.Zortress (everolimus) US prescribing information. Novartis Pharmaceuticals Corporation Sept, 2023.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.