Drug Interaction Report

Lapatinib and Cyclosporine Ophthalmic: Interaction Details

A pharmacist-reviewed analysis of the Lapatinib and Cyclosporine Ophthalmic 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

Cyclosporine Ophthalmic

Cequa Cequa® Restasis® Vevye
+

Lapatinib

Tykerb Tykerb®
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 86 documented Lapatinib interactions, 80 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

CycloSPORINE is a CYP3A4 substrate with a narrow therapeutic window and a P-gp substrate1, and lapatinib is a weak CYP3A4 inhibitor and a P-gp inhibitor. Although not studied with cycloSPORINE, the coadministration of oral or IV midazolam, also a CYP3A4 substrate, and lapatinib resulted in midazolam AUC increasing by 45% and 22%, respectively. Similarly, the coadministration of cycloSPORINE with lapatinib may result in increased cycloSPORINE plasma concentrations. Dosage adjustment of cycloSPORINE may be required when coadministered with lapatinib 2.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of cycloSPORINE by lapatinib; inhibition of P-gp-mediated efflux transport of cycloSPORINE

Literature reports

1 report — tap to read

a) Although not studied with cycloSPORINE, the coadministration of oral or IV midazolam, also a CYP3A4 substrate, and lapatinib resulted in midazolam AUC increasing by 45% and 22%, respectively 2.

Common questions

Can I take Lapatinib and Cyclosporine Ophthalmic together?

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

How serious is the Lapatinib and Cyclosporine Ophthalmic 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 Lapatinib or Cyclosporine Ophthalmic 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: TYKERB(R) oral tablets, lapatinib oral tablets. GlaxoSmithKline (per FDA), Research Triangle Park, NC, 2011. DailyMed
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Cyclosporine Ophthalmic

Keep reading about Cyclosporine Ophthalmic

All Cyclosporine Ophthalmic interactions (545) Cyclosporine Ophthalmic drug information
Also serious with: Dronedarone Elagolix Ensitrelvir Ezetimibe
Lapatinib

Keep reading about Lapatinib

All Lapatinib interactions (86) Lapatinib drug information
Also serious with: Colchicine Oxaliplatin Injection Hydroxychloroquine Metronidazole Injection
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:

Lapatinib + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 135 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.