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Ciclosporin and grapefruit — GPhC CRA MCQ

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ModerateDrug InteractionsCiclosporin and grapefruitGPhC CRA

A renal transplant recipient taking ciclosporin asks whether grapefruit juice is a healthy option with breakfast. His ciclosporin levels have been stable. He takes no other interacting medicines. What is the most important interaction to flag?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Grapefruit juice can increase ciclosporin concentration

Grapefruit juice inhibits intestinal CYP3A4 and can increase ciclosporin exposure. This may increase nephrotoxicity and other adverse effects. Transplant patients should be advised to avoid grapefruit unless their specialist team has given specific advice.

Reference: BNF