Interaction between Cyclosporine and Rosuvastatin
Major Metabolism

ID DDInter458 and DDInter1622
Interaction Coadministration with cyclosporine may significantly increase the plasma concentrations of rosuvastatin. The proposed mechanism is cyclosporine inhibition of the hepatic uptake of rosuvastatin via organic anion transporting polypeptide C (OATP-C). Rosuvastatin did not affect the plasma concentrations of cyclosporine.
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Management The daily dosage of rosuvastatin should not exceed 5 mg when used in combination with cyclosporine. Patients should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. Rosuvastatin should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.
References
Alternative for Cyclosporine L04A
Alefacept
Muromonab
Canakinumab
Cladribine
Secukinumab
Efalizumab
Antithymocyte immunoglobulin (rabbit)
Brodalumab
Natalizumab
Mycophenolic acid
Ixekizumab
More
Alternative for Rosuvastatin C10A
Cholestyramine
Dextrothyroxine
Bempedoic acid
Colestipol

A10B
Lixisenatide
Semaglutide
Dapagliflozin
Alogliptin
Liraglutide
Dulaglutide
Miglitol
More

Potential Metabolism Interactions

Substrate-Substrate Interaction：If more than one drug is metabolized by the same CYP, it is possible that its metabolism is inhibited because of the competition between the drugs. That means, it can be useful to lower the dosage of the drugs in the drug-cocktail because they remain longer in the organism than in monotherapy.
Inhibitor-Inhibitor Interaction：Combining two or more inhibitors of one CYP, should be compensated by lowering the dosage of these drugs because the metabolism is reduced and the drugs remain longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.
Inhibitor-Substrate Interaction：Combining drugs that have inhibitory effect and are substrates of one particular CYP, should be compensated by lowering the dosage. They rest longer in the organism than in monotherapy. Not adapting the dosage bears the risk of even more side effects.