Drug General Information (ID: DDIWNDSCMV)
Drug Name			Cyclosporine		Drug Info		Salsalate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiviral Agents				Antiinflammatory Agents
Structure

Mechanism of Cyclosporine-Salsalate Interaction (Severity Level: Moderate)
Increased risk of nephrotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Salsalate
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 Salsalate

Recommended Action
Management		Renal function should be closely monitored in patients receiving concomitant therapy with cyclosporine and NSAIDs.

References
1	Branthwaite JP, Nicholls A "Cyclosporin and diclofenac interaction in rheumatoid arthritis." Lancet 337 (1991): 252. [PMID: 1670893]
2	Brouwers JRBJ, Desmet PAGM "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet 27 (1994): 462-85. [PMID: 7882636]
3	Deray G, Le Hoang P, Aupetit B, Achour A, Rottembourg J, Baumelou A "Enhancement of cyclosporine A nephrotoxicity by diclofenac." Clin Nephrol 27 (1987): 213-4. [PMID: 2953512]
4	Harris KP, Jenkins D, Walls J "Nonsteroidal antiinflammatory drugs and cyclosporine." Transplantation 46 (1988): 598-9. [PMID: 3176159]
5	Product Information. Arthrotec (diclofenac-misoprostol). Searle, Skokie, IL.
6	Sesin GP, O'Keefe E, Roberto P "Sulindac-induced elevation of serum cyclosporine concentration." Clin Pharm 8 (1989): 445-6. [PMID: 2663332]