Drug & supplement interaction

Wine + Cyclosporine

Cyclosporine brand names: Neoral, Gengraf, Sandimmune, Ciclosporine, Cequa, and others.

Major Interaction
Medically reviewed by · Updated September 2026
The bottom line Major

Cyclosporine falls into 2 drug categories that Wine can interact with; the most serious is rated major. Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.

Read the full interaction report
SeverityMajor
LikelihoodProbable
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Wine and Cyclosporine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Wine interacts with whole categories of medication. Cyclosporine falls into 2 of those categories, so it can interact with Wine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Major).

Major

HEPATOTOXIC DRUGS

1 of 2

Why this applies to Cyclosporine

Cyclosporine falls under HEPATOTOXIC DRUGS — the group Wine interacts with.

Concomitant use of alcohol with hepatotoxic drugs may increase the risk of hepatotoxicity.
Concomitant use of excessive amounts of alcohol with potentially hepatotoxic drugs can increase the risk of liver damage.
Severity Major Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with mixing wine and cyclosporine: both can be tough on your liver. Cyclosporine is one of those medications that needs careful monitoring because it can stress the liver and kidneys, and adding regular or heavy drinking on top of it raises the chance of liver damage. Watch for signs like yellowing of the skin or eyes, dark urine, belly pain, or unusual tiredness.

This is a recognized, agreed-upon caution rather than something proven by big studies, and an occasional small glass is different from drinking heavily. Still, cyclosporine is a sensitive drug where small problems can become big ones. Please don't change anything on your own. Talk with your transplant team or pharmacist about whether any alcohol is okay for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Major

CYCLOSPORINE (Neoral, Sandimmune)

2 of 2
Red wine can reduce the levels and clinical effects of cyclosporine.
Red wine reduces plasma cyclosporine concentrations, possibly by reducing cyclosporine absorption. There is evidence the reduction in cyclosporine AUC by red wine is less in Asians (8% to 14%) than Caucasians (35% to 36%).
Severity Major Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical concern with red wine and your cyclosporine. Cyclosporine is an active drug, not a prodrug, and it works by quietly holding your immune system back. The catch is that your body has to absorb enough of it to do that job. Studies suggest red wine can lower how much cyclosporine your body takes in, dropping blood levels by roughly a third in some people. With less drug on board, you risk weaker protection, which for a transplant patient means a higher chance of organ rejection, or for arthritis or psoriasis, a return of symptoms.

Cyclosporine is a medication where small swings in level genuinely matter, so this isn't something to brush off. Please don't change anything on your own. Talk with your transplant team or pharmacist about alcohol and any level monitoring.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Tsunoda SM, Christians U, Velez RL, et al. Red wine (RW) effects on cyclosporine (CyA) metabolites. Clin Pharmacol Ther 2000;67:150 (abstract PIII-35).
  2. Tsunoda SM, Harris RZ, Velez RL, et al. Red wine (RW) effects on cyclosporine (CyA) Pharmacokinetics. Clin Pharmacol Ther 1998;65:159 (abstract PII-51). DOI
  3. Tsunoda SM, Harris RZ, Christians U, et al. Red wine decreases cyclosporine bioavailabity. Clin Pharmacol Ther 2001;70:462-7.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Wine Also Interacts With Other Medications

Wine has 655 major, 270 moderate known drug interactions in our database — the Cyclosporine one above is among them. If you take anything else, check it against the full list below.

Major 655 Moderate 270 No known interaction 1,905 (incl. Cyclosporine)
Taking anything else?

Check Another of Your Medications Against Wine

Covers the 2,830 medications we’ve checked against Wine. Pick one to open its full report.

From our Q&A

Questions About Wine or Cyclosporine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Wine or Cyclosporine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Cyclosporine

This page covers Wine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cyclosporine page lists 229 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Berberine (major) and Grapefruit (major).

By severity: 9 major · 182 moderate · 38 minor.

From our pharmacist’s overview on the Cyclosporine page

“Cyclosporine (Neoral, Sandimmune, Gengraf) keeps a transplanted organ from being rejected, and small shifts in its blood level can tip you toward rejection on one side or toxicity on the other. So approach these 229 interacting supplements with real care.”

Reviewed by 2 · Jul 18, 2026

Open the Cyclosporine interaction page

One more smart check

Taking Wine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Your product may carry other ingredients that interact with Cyclosporine too, on top of Wine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Wine and Cyclosporine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Wine
Top half

#435 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Cyclosporine
Top 25%

#301 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Read the full Wine monograph & all interactions
Medication

About Cyclosporine

What Is Cyclosporine Used For?

Brand names: Neoral, Gengraf, Sandimmune, Ciclosporine, Cequa, Verkazia, Vevye

Oral cyclosporine (such as Gengraf, Neoral and the modified generic capsules and solution) is used to prevent organ rejection in kidney, liver and heart transplants. It is also used for severe active rheumatoid arthritis that has not responded well enough to methotrexate. It is also used for severe, hard-to-treat plaque psoriasis in adults with normal immune systems.

Sandimmune capsules and injection, used with corticosteroids, prevent organ rejection and treat chronic rejection in people previously treated with other immune-suppressing medicines. Eye products have different uses. Restasis, Restasis MultiDose and generic cyclosporine eye emulsion increase tear production in dry eye linked to eye inflammation. Cequa increases tear production in keratoconjunctivitis sicca (dry eye). Vevye treats signs and symptoms of dry eye disease. Verkazia treats vernal keratoconjunctivitis in children and adults.

See full Cyclosporine drug information
Keep checking

Other Drugs & Wine

Browse every other medication we’ve checked against Wine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

655Major
270Moderate
0Minor
1,904No known interaction
655 Major 270 Moderate 1,904 No interaction
Major

655 interactions

Showing 60 of 655 major interactions — see all 655 on the Wine page.

Moderate

270 interactions

Showing 60 of 270 moderate interactions — see all 270 on the Wine page.

No interaction 1,904 drugs checked — show the list

We also checked Wine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Wine list.

See the full Wine interactions page
See every supplement checked against Cyclosporine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Wine monograph › Uses, safety, and every drug interaction in one place Cyclosporine supplement interactions › Every supplement checked against Cyclosporine, ranked by severity Cyclosporine drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Wine and Cyclosporine Together: Common Questions

Can you take Wine with Cyclosporine?
This is rated a major interaction, so the combination is best avoided unless your doctor or pharmacist has specifically told you otherwise. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Wine and Cyclosporine?
Cyclosporine belongs to more than one drug category, and Wine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Wine and Cyclosporine interaction?
We rate it Major. This is a clinically significant combination that is generally best avoided, or used only under the direct supervision of your physician or pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Cyclosporine and Wine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.