Drug General Information (ID: DDIIW4Q7OV)
Drug Name			Darbepoetin alfa		Drug Info		Cyclosporine		Drug Info
Drug Type		Protein/peptide				Small molecule
Therapeutic Class		Antianemic Agents				Antiviral Agents

Mechanism of Darbepoetin alfa-Cyclosporine Interaction (Severity Level: Moderate)
Additive hypertensive effects Click to Show/Hide Mechanism Graph
Drug Name		Darbepoetin alfa				Cyclosporine
Mechanism		Hypertensive effects				Hypertensive effects
Key Mechanism Factor 1
		Factor Name		Hypertensive effects
		Factor Description		Hypertension is defined as a blood pressure reading above a prescribed limit (130/90 mmHg). Most people with hypertension have no signs or symptoms; others may experience: severe headache, shortness of breath, nosebleeds, severe anxiety, and feeling a tingling sensation in the neck or head.
Mechanism Description		Additive hypertensive effects by the combination of Darbepoetin alfa and Cyclosporine

Recommended Action
Management		Caution is advised if cyclosporine is prescribed in combination with ESAs. Blood pressure should be adequately controlled before initiating treatment and monitored periodically during treatment. Patients who develop hypertension that is difficult to control by medications or dietary measures should have their ESA treatment reduced or withheld. In addition, cyclosporine blood levels should be checked regularly, as changes may occur following the addition, withdrawal, or change of dosage of ESA therapy. Dosage adjustments for cyclosporine may be required with increases in hematocrit levels.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	Ducharme MP, Warbasse LH, Edwards DJ "Disposition of intravenous and oral cyclosporine after administration with grapefruit juice." Clin Pharmacol Ther 57 (1995): 485-91. [PMID: 7768070]