An isolated report describes development of nephrotoxicity,which was attributed to an interaction between ciclosporin anddisopyramide
Clinical evidence,mechanism, importance and management
Ten months after receiving a kidney transplant a 40-year-old woman developed premature ventricular beats and was therefore given oxprenolol in addition to her usual ciclosporin and methylprednisolone. After 2 months she had shown no improvement so she started taking disopyramide 100mg three times daily. Over next week her serum creatinine rose from 88 to 159 micromol/L, at which point disopyramide was stopped. Her renal function returned to normal over next week. As she had previously been stable taking ciclosporin,and, as nephrotoxicity had not been reported with disopyramide, an interaction was suspected (See reference number 1).
This interaction is unconfirmed and of uncertain clinical significance. There is insufficient evidence to recommend increased monitoring, but be aware of potential for an interaction in case of an unexpected response to treatment.
1. Nanni G,Magalini SC, Serino F, Castagneto M. Effect of disopyramide in a cyclosporine-treated patient. Transplantation (1988) 45, 257.