Prednisolone and Cyclosporine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Prednisolone
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
An increased risk of cycloSPORINE toxicity (renal dysfunction, cholestasis, paresthesias) and symptoms of steroid excess
Interaction Deep Dive
The concomitant use of cycloSPORINE and prednisoLONE has resulted in an increased trough cycloSPORINE concentration. Symptoms of corticosteroid excess have also been observed with prednisoLONE56. CycloSPORINE may reduce the clearance of prednisoLONE 12.
Why it happens (mechanism)
Competitive inhibition of hepatic metabolism
Literature reports
2 reports — tap to read
a) Concomitant administration of prednisoLONE or methylprednisolone and cycloSPORINE results in mutual inhibition of metabolism, resulting in increased plasma levels of both drugs 53.
b) The effect of cycloSPORINE on the elimination of prednisoLONE is controversial. CycloSPORINE significantly reduced the elimination of prednisoLONE, resulting in increased serum levels of the steroid 4. However, results of other studies have indicated that cycloSPORINE has no significant effect on the elimination of prednisoLONE 76.
Common questions
Can I take Prednisolone and Cyclosporine Injection together?
An increased risk of cycloSPORINE toxicity (renal dysfunction, cholestasis, paresthesias) and symptoms of steroid excess Always confirm with your pharmacist or prescriber before making any change.
How serious is the Prednisolone 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.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Prednisolone 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 (7)
- 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
- Baciewicz AM & Baciewicz FA Jr: Cyclosporine pharmacokinetic drug interactions. Am J Surg 1989; 157:264-271. PubMed
- Ost L: Effects of cyclosporin on prednisolone metabolism (letter). Lancet 1984; 1:451. PubMed
- Klintmalm G & Sawe J: High dose methylprednisolone increases plasma cyclosporin levels in renal transplant recipients (letter). Lancet 1984; 1:731. PubMed
- Rocci ML Jr, Tietze KJ, Lee J, et al: The effect of cyclosporine on the pharmacokinetics of prednisolone in renal transplant patients. Transplantation 1988; 45:656-660. PubMed
- Frey FJ, Schnetzer A, Horber FF, et al: Evidence that cyclosporine does not affect the metabolism of prednisolone after renal transplantation. Transplantation 1987; 43:494-498. PubMed
Keep reading about Prednisolone
Keep reading about Cyclosporine Injection
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