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Ciclosporin and clarithromycin — GPhC CRA MCQ

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HardDrug InteractionsCiclosporin and clarithromycinGPhC CRA

A patient taking ciclosporin after renal transplant is prescribed clarithromycin for sinusitis. They report tremor and recent creatinine rise from 110 to 150 micromol/L. What is the most important interaction to flag?

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Correct answer: A — Clarithromycin can increase ciclosporin concentration and nephrotoxicity

Clarithromycin can inhibit ciclosporin metabolism, increasing levels and toxicity. The creatinine rise and tremor heighten concern for ciclosporin toxicity. The prescriber or transplant team should be contacted urgently for antibiotic selection and drug-level monitoring.

Reference: BNF