Drug Interaction Report

Crizotinib and Cyclosporine Injection: Interaction Details

A pharmacist-reviewed analysis of the Crizotinib and Cyclosporine Injection interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Crizotinib

Xalkori
+

Cyclosporine Injection

Atopica Cequa Cyclavance Gengraf Modulis Neoral Optimmune Restasis
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 138 documented Crizotinib interactions, 123 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased cycloSPORINE exposure

Interaction Deep Dive

The concomitant use of cycloSPORINE (a CYP3A substrate with a narrow therapeutic range) with crizotinib (a moderate CYP3A inhibitor) should be avoided due to a risk of increased cycloSPORINE plasma concentrations. Although not specifically studied with cycloSPORINE, a drug interaction study of crizotinib and oral midazolam (another CYP3A substrate) found that concomitant use with crizotinib increased midazolam AUC by 3.7-fold compared with midazolam exposure alone2. If concomitant use of crizotinib and cycloSPORINE is required, monitoring of cycloSPORINE plasma concentrations and appropriate cycloSPORINE dosage adjustment are essential 1.

Why it happens (mechanism)

Inhibition of CYP3A-mediated cycloSPORINE metabolism by crizotinib

Literature reports

1 report — tap to read

a) In a drug interaction study of crizotinib and midazolam (a CYP3A substrate), concomitant use of crizotinib 250 mg twice daily for 28 days with oral midazolam resulted in a geometric mean midazolam AUC that was 3.7-fold that reported with midazolam administration alone 2.

Common questions

Can I take Crizotinib and Cyclosporine Injection together?

Increased cycloSPORINE exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Crizotinib and Cyclosporine Injection interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

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 Crizotinib 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 a safer alternative to one of these medications for me?

References (2)

  1. Product Information: SANDIMMUNE(R) oral capsules, oral solution, intravenous injection, cyclosporine oral capsules, oral solution, intravenous injection. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
  2. Product Information: XALKORI(R) oral pellets, oral capsules, crizotinib oral pellets, oral capsules. Pfizer Labs (per FDA), New York, NY, 2023. DailyMed
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Crizotinib

Keep reading about Crizotinib

All Crizotinib interactions (138)
Also serious with: Ketoconazole Topical Docetaxel Gatifloxacin Ophthalmic Amitriptyline
Cyclosporine Injection

Keep reading about Cyclosporine Injection

All Cyclosporine Injection interactions (545) Cyclosporine Injection drug information
Also serious with: Ezetimibe Grazoprevir Sitaxsentan Simvastatin
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Crizotinib + Activated Charcoal American Hellebore Arsenic Cesium Ephedra Grapefruit Sida Cordifolia St. John's Wort + 149 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.