Glecaprevir 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
Glecaprevir
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
Increased glecaprevir exposure and an increased cycloSPORINE exposure
Interaction Deep Dive
Concurrent use of cycloSPORINE and glecaprevir/pibrentasvir may result in increased glecaprevir plasma levels. Coadministration of cycloSPORINE and glecaprevir/pibrentasvir is not recommended for patients requiring stable cycloSPORINE doses greater than 100 mg/day. In a pharmacokinetic study, when a single dose of cycloSPORINE 100 mg was coadministered with glecaprevir 300 mg/pibrentasvir 120 mg once daily, glecaprevir Cmax increased by 30%, AUC increased by 37%, and Cmin increased by 34%. Coadministration of a single dose of cycloSPORINE 400 mg with a single dose of glecaprevir 300 mg/pibrentasvir 120 mg resulted in an increase in Cmax by 351% and an increase in AUC by 408%3. Also, coadministration of cycloSPORINE (a P-gp substrate) with glecaprevir (a P-gp inhibitor) may increase the concentrations of cycloSPORINE. Adjust cycloSPORINE dosage to achieve the desired cycloSPORINE concentrations when these drugs are administered concomitantly 12.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of glecaprevir; inhibition of OATP1B1-mediated efflux transport of glecaprevir; inhibition of OATP1B3-mediated efflux transport of glecaprevir; inhibition of P-gp-mediated efflux transport of cycloSPORINE
Literature reports
1 report — tap to read
a) In a pharmacokinetic study (n=12), when a single dose of cycloSPORINE 100 mg was coadministered with glecaprevir 300 mg/pibrentasvir 120 mg once daily, glecaprevir Cmax increased by 30%, AUC increased by 37%, and Cmin increased by 34%. Coadministration of a single dose of cycloSPORINE 400 mg with a single dose of glecaprevir 300 mg/pibrentasvir 120 mg (n=11) resulted in an increase in Cmax by 351% and an increase in AUC by 408% 3.
Common questions
Can I take Glecaprevir and Cyclosporine Injection together?
Increased glecaprevir exposure and an increased cycloSPORINE exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Glecaprevir 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 "established". Well documented — supported by controlled studies or strong clinical data.
Questions for your pharmacist
- Does my dose of Glecaprevir 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 (3)
- Product Information: NEORAL(R) oral soft gelatin capsules oral solution, cyclosporine modified oral soft gelatin capsules oral solution. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
- 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
- Product Information: MAVYRET(R) oral tablets, oral pellets, glecaprevir pibrentasvir oral tablets, oral pellets. AbbVie Inc (per FDA), North Chicago, IL, 2023. DailyMed
Keep reading about Cyclosporine Injection
Keep reading about Glecaprevir
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