Drug General Information (ID: DDIWYIZJ1F)
Drug Name			Cyclosporine		Drug Info		Kaolin		Drug Info
Drug Type		Small molecule				Natural product
Therapeutic Class		Antiviral Agents				Herbal Products
Structure

Mechanism of Cyclosporine-Kaolin Interaction (Severity Level: Moderate)
Complex formation Click to Show/Hide Mechanism Graph
Drug Name		Cyclosporine				Kaolin
Mechanism		Binds to polyvalent cations				Polyvalent cations
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 Kaolin due to formation of complexes caused by Cyclosporine

Recommended Action
Management		Oral cyclosporine should be administered 2 hours before or 6 hours after the aluminum salt in order to avoid this potential interaction. The patient's therapeutic response should be monitored.

References
1	Ichisawa M, Ohta I, Suzuki R, et al. "The effect of dried aluminum hydroxide gel on the blood concentration of cyclosporine-A." Jpn J Hosp Pharm 23 (1997): 407-13.