Amiodarone and Cyclosporine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Amiodarone
Cyclosporine Injection
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased plasma levels of cycloSPORINE
Interaction Deep Dive
The concomitant administration of amiodarone and cycloSPORINE may increase cycloSPORINE levels, leading to elevated creatinine levels despite reductions in the dose of cycloSPORINE1. Case reports of patients who were coadministered amiodarone and cycloSPORINE showed increased cycloSPORINE levels compared with baseline (cycloSPORINE administered alone) 643. Monitor cycloSPORINE levels and renal function in patients concomitantly administered amiodarone and cycloSPORINE 1.
Why it happens (mechanism)
Unknown
Literature reports
4 reports — tap to read
a) A 66-year-old female kidney transplant patient experienced an increase in cycloSPORINE levels from 100 to 150 nanogram/mL (83.2 to 124.7 nanomol/L) to 265 ng/mL (220.4 nanomol/L) three days after the addition of amiodarone 1200 mg daily. CycloSPORINE dosage reduction from 500 mg daily to 360 mg daily resulted in therapeutic cycloSPORINE levels of 125 +/- 50 nanogram/mL (103.9 +/- 41.6 nanomol/L) 2.
b) CycloSPORINE clearance was reduced by 50% after concomitant use of amiodarone for 44 days in a 47-year-old male heart transplant patient. Upon the discontinuation of amiodarone, cycloSPORINE clearance rapidly returned to baseline 3.
c) Concomitant administration of amiodarone and cycloSPORINE to eight heart or heart-lung transplant patients resulted in increased cycloSPORINE levels over baseline 4.
d) Five patients who were receiving amiodarone prior to heart transplantation exhibited increased cycloSPORINE metabolism after the discontinuation of the antiarrhythmic therapy. Seven to 28 days following heart transplantation, total cycloSPORINE metabolites averaged 1210 nanogram/mL in patients previously treated with amiodarone compared to 650 nanogram/mL in patients who were not receiving amiodarone. In two of these patients, the increased cycloSPORINE metabolism lasted for more than five weeks 5.
Common questions
Can I take Amiodarone and Cyclosporine Injection together?
Increased plasma levels of cycloSPORINE Always confirm with your pharmacist or prescriber before making any change.
How serious is the Amiodarone and Cyclosporine Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Amiodarone or Cyclosporine Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (6)
- Product Information: Cordarone(R) oral tablets, amiodarone HCl oral tablets. Wyeth Pharmaceuticals Inc (per FDA), Philadelphia, PA, 2016. DailyMed
- Chitwood K, Abdul-Haqq A, & Heim-Duthoy K: Cyclosporine- amiodarone interaction. Ann Pharmacother 1993; 27:569-571. PubMed
- Nicolau D, Uber W, Crumbley A III, et al: Amiodarone-cyclosporine interaction in a heart transplant patient. J Heart Lung Transplant 1992; 11:564-568.
- Mamprin F, Mullins P, Graham T, et al: Amiodarone-cyclosporine interaction in cardiac transplantation. Am Heart J 1992; 123:1725-1726. PubMed
- Preuner JG, Lehle K, Keyser A, et al: Development of severe adverse effects after discontinuing amiodarone therapy in human heart transplant recipients. Transplant Proc 1998; 30:3943-3944. PubMed
- Chitwood K, Abdul-Haqq A, & Heim-Duthoy K: Cyclosporine-amiodarone interaction. Ann Pharmacother 1993; 27:569-571. PubMed
Keep reading about Amiodarone
Keep reading about Cyclosporine Injection
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