Drug General Information (ID: DDID0YJ48O)
Drug Name			Cyclosporine		Drug Info		Iodixanol		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Non-Ionic Iodinated Contrast Media
Structure

Mechanism of Cyclosporine-Iodixanol Interaction (Severity Level: Major)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Iodixanol
Mechanism		Nephrotoxicity				Nephrotoxicity
Key Mechanism Factor 1
		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 Iodixanol

Recommended Action
Management		alternative imaging techniques that do not require contrast should be considered in patients who are at increased risk for contrast-induced nephropathy. Any repeat procedures with contrast media, if necessary, should not occur until at least 48 to 72 hours after the previous contrast exposure and renal function has fully recovered.

References
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3	Bentley ML, Corwin HL, Dasta J "Drug-induced acute kidney injury in the critically ill adult: recognition and prevention strategies." Crit Care Med 38(6 Suppl) (2010): S169-74. [PMID: 20502171]
4	Dubrovskaya Y, Prasad N, Lee Y, Esaian D, Figueroa DA, Tam VH "Risk factors for nephrotoxicity onset associated with polymyxin B therapy." J Antimicrob Chemother 70 (2015): 1903-7. [PMID: 25652747]
5	Kellum JA, Leblanc M, Venkataraman R "Acute renal failure." BMJ Clin Evid 9 (2008): 2001. [PMID: 19445797]
6	Marcos LA, Camins BC, Ritchie DJ, Casabar E, Warren DK "Acute renal insufficiency during telavancin therapy in clinical practice." J Antimicrob Chemother 67 (2012): 723-6. [PMID: 22174040]
7	van den Berk G, Tonino S, de Fijter C, Smit W, Schultz MJ "Bench-to-bedside review: Preventative measures for contrast-induced nephropathy in critically ill patients." Crit Care 9 (2005): 361-70. [PMID: 16137385]