Drug General Information (ID: DDILW0ER3C)
Drug Name			Cyclosporine		Drug Info		Sevelamer		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Phosphate Binders
Structure

Mechanism of Cyclosporine-Sevelamer Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Sevelamer
Mechanism		Binds to anion exchange resin/polymer				Anion exchange resin/polymer
Key Mechanism Factor 1
		Factor Name		Chelation
		Factor Description		Chelation is a direct drug interaction that usually involves the formation of dimers or trimers, resulting in larger complexes and poorer absorption.
Mechanism Description		Decreased absorption of Sevelamer due to formation of complexes caused by Cyclosporine

Recommended Action
Management		The immunosuppressant may be given at least 1 to 2 hours before or 2 to 3 hours after sevelamer administration to minimize the impact on absorption. It is recommended to closely monitor blood concentrations of the immunosuppressant during concomitant use and after discontinuation of sevelamer.

References
1	Cerner Multum, Inc. "Australian Product Information.".
2	Cerner Multum, Inc. "UK Summary of Product Characteristics.".
3	EMEA. European Medicines Agency "EPARs. European Union Public Assessment Reports.".
4	Product Information. CellCept (mycophenolate mofetil). Roche Laboratories, Nutley, NJ.