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Ciclosporin Toxicity — RACP Adult Medicine MCQ

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EasyNephrologyCiclosporin ToxicityRACP Adult Medicine

A 55-year-old renal transplant recipient on ciclosporin presents with gingival hyperplasia, hirsutism, tremor, and hypertension. His creatinine has risen from 120 to 180 μmol/L. Ciclosporin trough level is elevated. What is the most likely causative immunosuppressant?

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Correct answer: E — Ciclosporin

Gingival hyperplasia, hirsutism, tremor, hypertension, and nephrotoxicity are characteristic side effects of ciclosporin. It causes afferent arteriolar vasoconstriction in the kidney. Drug interactions via CYP3A4 are common. Compared to tacrolimus, ciclosporin causes more hirsutism and gingival hyperplasia, while tacrolimus causes more diabetes and alopecia.

Reference: AMH – 2025 – Ciclosporin; TSANZ 2024