Autumn Crocus and Cyclosporine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cyclosporine Injection
Autumn Crocus
No brand names on record
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
Gastrointestinal dysfunction, hepatonephropathy, and neuromyopathy
Interaction Deep Dive
This interaction is based on the interaction of prescription colchicine with cycloSPORINE. Autumn crocus may theoretically interact similarly due to its colchicine content. Concurrent therapy with colchicine and cycloSPORINE in four renal transplant patients led to pronounced side effects, ranging from diarrhea, elevation in liver enzymes, hyperbilirubinemia, and elevations in serum creatinine2. A 53-year-old heart transplant recipient experienced muscle pain, weakness, and gastrointestinal disturbances when cycloSPORINE and colchicine were coadministered 3. Hyperuricemia has been observed in 84% of renal-allograft recipients receiving cycloSPORINE, as compared with 30% of those receiving azathioprine, making it a common complication of cycloSPORINE therapy 1. When taken alone, colchicine may cause myopathy in patients who have elevated plasma drug levels because of altered renal function 4.
Why it happens (mechanism)
Inhibition of p-glycoprotein by cycloSPORINE, impairing liver and renal colchicine excretion
Literature reports
2 reports — tap to read
a) A drug interaction was suspected while studying the conversion from azathioprine to cycloSPORINE therapy in four male renal transplant patients. All four patients were receiving azathioprine 1 mg/kg (milligram/kilogram) to 2 mg/kg, prednisone 10 mg daily, and prophylactic colchicine therapy at 1 to 2 mg daily. The conversion protocol consisted of the gradual addition of cycloSPORINE therapy, starting at 3 mg/kg, to the patient's medication until therapeutic levels of cycloSPORINE were reached. At the very earliest stages of conversion, all patients developed pronounced side effects, ranging from diarrhea, elevation in serum lactic dehydrogenase (LDH), elevation in serum alanine aminotransferase (ALT), hyperbilirubinemia, and elevation in serum creatinine. One patient was hospitalized for general muscular weakness and severe myalgia. After cycloSPORINE was withdrawn, all four patients rapidly improved and adverse clinical symptoms resolved. The authors postulated that the symptoms were a direct result of combined therapy with colchicine and cycloSPORINE 2.
b) A 53-year-old male who had undergone two orthotopic heart transplant procedures was receiving cycloSPORINE 125 mg twice daily, prednisone 5 mg daily, furosemide 40 mg daily, insulin, and intermittent colchicine 0.5 mg three times daily. He started to complain of muscle pain and weakness which progressed to inability to rise from a chair. Upon admission to the hospital, his laboratory values revealed a creatinine level of 3.4 milligrams/deciliter (mg/dL), uric acid 11 mg/dL, CPK 3003 units/Liter (U/L), and a cycloSPORINE level of 125 micrograms/milliliter (mcg/mL). An echocardiogram and a myocardial biopsy were performed to rule out organ rejection. A quadriceps muscle biopsy showed nonspecific necrotizing myopathy. Colchicine was discontinued, and within several days the patient became asymptomatic while laboratory values returned to normal values within two weeks. The combination of cycloSPORINE and colchicine is believed to have precipitated the myopathy seen in this patient. CycloSPORINE blocks p-glycoprotein, which in turn impairs the liver and renal excretion of colchicine, causing elevated colchicine levels and possible cytotoxic drug accumulation 3.
Common questions
Can I take Autumn Crocus and Cyclosporine Injection together?
Gastrointestinal dysfunction, hepatonephropathy, and neuromyopathy Always confirm with your pharmacist or prescriber before making any change.
How serious is the Autumn Crocus 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 "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Autumn Crocus 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 (4)
- Lin HY, Rocher LL, McQuillan MA, et al: Cyclosporine-induced hyperuricemia and gout. N Engl J Med 1989; 321:287-292. PubMed
- Yussim A, Bar-Nathan N, Lustig S, et al: Gastrointestinal, hepatorenal, and neuromuscular toxicity caused by cyclosporine-colchicine interaction in renal transplantation. Transplant Proc 1994; 26:2825-2826.
- Gruberg L, Har-Zahav Y, Agranat O, et al: Acute myopathy induced by colchicine in a cyclosporine treated heart transplant recipient: possible role of the multidrug resistance transporter. Transplant Proc 1999; 31:2157-2158. PubMed
- Kuncl RW, Duncan G, Watson D, et al: Colchicine myopathy and neuropathy. N Engl J Med 1987; 316:1562-1568. DOI
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