Ciclosporin Gingival Overgrowth — MFDS Part 1 MCQ

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ModerateHuman DiseaseCiclosporin Gingival OvergrowthMFDS Part 1

A renal transplant recipient develops progressive fibrotic gingival enlargement together with increased body-hair growth after starting immunosuppressive therapy. Which medication is most likely responsible for this combination?

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Correct answer: A — Ciclosporin

Ciclosporin is the best answer. Current SDCEP periodontal guidance identifies ciclosporin as a cause of drug-influenced gingival enlargement, and its UK SmPC lists gingival hyperplasia together with hirsutism and hypertrichosis. This combination of oral and hair-growth effects therefore provides the decisive discrimination. Mycophenolate mofetil is a particularly important distractor because its SmPC also records gingival hyperplasia; this made the original question, which asked only which drug “can” cause overgrowth, non-unique. However, it is not characteristically associated with the combined presentation given here. Tacrolimus is another calcineurin inhibitor but does not have the same classic oral adverse-effect profile. Azathioprine and prednisolone are not recognised by SDCEP as principal causes of drug-influenced gingival enlargement.

Reference: Electronic Medicines Compendium, Capimune 100 mg soft capsules, Summary of Product Characteristics, section 4.8 Undesirable effects, current 2026: https://www.medicines.org.uk/emc/product/695/smpc