Tinidazole and Cyclosporine Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Tinidazole
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
Increased levels of cycloSPORINE
Interaction Deep Dive
Tinidazole, a nitroimidazole, is chemically-related to metronidazole3. Several case reports suggested that coadministration of metronidazole and cycloSPORINE was associated with increased cycloSPORINE levels 112. Although not specifically studied with tinidazole, similar to metronidazole, tinidazole may have the potential to elevate serum cycloSPORINE levels when administered concurrently. Monitor patients for signs of cycloSPORINE toxicity (nephrotoxicity, cholestasis, paresthesias) 3.
Why it happens (mechanism)
Unknown
Literature reports
3 reports — tap to read
a) A 50-year-old male with a cadaveric renal allograft was stabilized on cycloSPORINE 125 milligrams (mg) twice daily with a trough cycloSPORINE concentration between 130 micrograms per liter (mcg/L) and 150 mcg/L. Following a three-day history of vomiting and diarrhea, a stool culture isolated Campylobacter coli for which he was treated with metronidazole 400 mg three times daily for one week. His illness resolved over three days, but the cycloSPORINE level increased to 264 mcg/L and his serum creatinine increased from 0.17 millimoles per liter (mmol/L) to 0.19 mmol/L. Following the discontinuation of metronidazole, cycloSPORINE levels decreased to 120 mcg/L and renal function returned to baseline 1.
b) Another case report described a patient who experienced a 97% increase in his cycloSPORINE blood level when metronidazole 1200 mg daily was administered for one week 1.
c) In a case report, the combined use of metronidazole 1500 milligrams (mg) daily and cimetidine 800 mg daily resulted in a greater than two-fold increase in cycloSPORINE levels (from 400 to 800 micromoles per liter (mcM/L)). When cimetidine was discontinued, levels declined to about 600 mcM/L. It was not until metronidazole was discontinued that cycloSPORINE levels returned to baseline 2.
Common questions
Can I take Tinidazole and Cyclosporine Injection together?
Increased levels of cycloSPORINE Always confirm with your pharmacist or prescriber before making any change.
How serious is the Tinidazole 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 "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 Tinidazole 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 (3)
- Herzig K & Johnson DW: Marked elevation of blood cyclosporin and tacrolimus levels due to concurrent metronidazole therapy (letter). Nephrol Dial Transplant 1999; 14:521-523. PubMed
- Zylber-Katz E, Rubinger D, & Berlatzky Y: Cyclosporine interactions with metronizadole and cimetidine. DICP 1988; 22:504-505.
- Product Information: TINDAMAX(R) oral tablets, tinidazole oral tablets. Mission Pharmacal Company, San Antonio, TX, 2007. DailyMed
Keep reading about Tinidazole
Keep reading about Cyclosporine Injection
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