Ranitidine and Cyclosporine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Ranitidine
No brand names on recordCyclosporine 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
Increased risk of renal dysfunction and an increased cycloSPORINE exposure
Interaction Deep Dive
Use caution when using cycloSPORINE with other drugs which are known to impair renal function like raNITIdine. During the concomitant use of a drug that may exhibit additive or synergistic renal impairment with cycloSPORINE, close monitoring of renal function (serum creatinine) should be performed. Also, coadministration of cycloSPORINE (a CYP3A4 substrate) with raNITIdine ( a CYP3A4 inhibitor) may increase cycloSPORINE exposure. If a significant impairment of renal function occurs, reduce the dosage of the cycloSPORINE and/or coadministered drug or consider an alternative treatment12. Concurrent use of cycloSPORINE and H2-receptor antagonists results in increased serum creatinine compared to cycloSPORINE use alone 4. This effect is more prominent with cimetidine compared with raNITIdine 3.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of cycloSPORINE
Literature reports
1 report — tap to read
a) In a study, the effect of cimetidine was found to be more pronounced than raNITIdine on creatinine clearance, when given with cycloSPORINE. It was shown that there was no significant difference in the clearance of inulin, indicating that the change in creatinine clearance was due to competition with cimetidine for tubular secretion; not due to a decrease in glomerular filtration or nephrotoxicity 3.
Common questions
Can I take Ranitidine and Cyclosporine Injection together?
Increased risk of renal dysfunction and an increased cycloSPORINE exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ranitidine 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 "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Ranitidine 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 (4)
- 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
- Pachon J, Lorber MI, & Bia MJ: Effects of H2-receptor antagonists on renal function in cyclosporine treated renal transplant patients. Transplantation 1989; 47:254-259. PubMed
- Jarowenko MV, Van Buren CT, Kramer WG, et al: Ranitidine, cimetidine and the cyclosporine-treated recipient. Transplantation 1986; 42:311-312. DOI
Keep reading about Ranitidine
Keep reading about Cyclosporine Injection
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