Drug General Information (ID: DDI2RUFC67)
Drug Name			Cyclosporine		Drug Info		Valganciclovir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Antiviral Agents
Structure

Mechanism of Cyclosporine-Valganciclovir Interaction (Severity Level: Moderate)
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Valganciclovir
Mechanism 1		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 1
		Factor Name		Myelosuppressive effects
		Factor Description		Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that leads to a decrease in the production of blood cells. Some blood cell disorders include: erythrocytopenia (anemia), leukopenia (neutropenia), and thrombocytopenia (thrombocytopenia).
Mechanism Description		Additive myelosuppressive effects by the combination of Cyclosporine and Valganciclovir
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Valganciclovir
Mechanism 2		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 2
		Factor Name		Nephrotoxicity
		Factor Description		The combination of drugs that can induce nephrotoxicity may increase the risk of kidney injury. When kidney injury occurs, the inability to remove excess urine and waste from the body can lead to high levels of urea nitrogen, creatinine, and electrolytes (such as potassium and magnesium) in the blood.
Mechanism Description		Increased risk of nephrotoxicity by the combination of Cyclosporine and Valganciclovir

Recommended Action
Management		Close monitoring of renal function and for the development of severe hematologic adverse effects is recommended. In addition, consideration should be given to discontinuing one or both drugs if an eye movement disorder occurs.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Openshaw H, Slatkin NE, Smith E "Eye movement disorders in bone marrow transplant patients on cyclosporin and ganciclovir." Bone Marrow Transplant 19 (1997): 5035. [PMID: 9052919]
4	Product Information. Cytovene (ganciclovir). Genentech, South San Francisco, CA.
5	Product Information. Neoral Soft Gelatin Capsules (cyclosporine). Sandoz Pharmaceuticals Corporation, East Hanover, NJ.