Calcineurin inhibitors (CNIs) | Inhibitors of mammalian (mechanistic) target of rapamycin (mTOR inhibitors) | Mycophenolate | Prednisone, prednisolone | |||
Cyclosporine | Tacrolimus | Sirolimus | Everolimus | |||
Travelers' diarrhea, self-treatment* | ||||||
Azithromycin¶ | May increase cyclosporine levels; effect is usually minor. Monitor clinical status. | May increase tacrolimus levels; effect is usually minor. Monitor clinical status. | May increase sirolimus levels; effect is usually minor. Monitor clinical status. | May increase everolimus levels; effect is usually minor. Monitor clinical status. | No interaction identified. | No interaction identified. |
Ciprofloxacin, levofloxacin, ofloxacin | Increased cyclosporine AUC in some studies, but not others; effect, if any, is minor. Clinical action generally not required. | Additive QTc-prolongation. Levofloxacin may increase tacrolimus AUC; effect is usually minor. Monitor clinical status. | No interaction identified. | No interaction identified. | May decrease mycophenolic acid levels (active form); effect is usually minor. Monitor clinical status. | Additive risk of tendinopathy.Δ |
Rifaximin | Increases systemic absorption of rifaximin.◊ | No interaction identified. | No interaction identified. | No interaction identified. | No interaction identified. | No interaction identified. |
Malaria prophylaxis | ||||||
Atovaquone-proguanil | Generally low risk of significant interactions with most maintenance immunosuppressive therapy. | |||||
Doxycycline | ||||||
Mefloquine | ||||||
Primaquine | ||||||
Tafenoquine | ||||||
Chloroquine, hydroxychloroquine | May increase cyclosporine levels; effect is usually minor. Monitor clinical status. | Additive QTc-prolongation (less with hydroxychloroquine). | No interaction identified. | No interaction identified. | No interaction identified. | No interaction identified. |
High altitude illness prophylaxis | ||||||
Acetazolamide§ | May increase cyclosporine levels; effect is usually minor. Monitor clinical status. | No interaction identified. | No interaction identified. | No interaction identified. | No interaction identified. | No interaction identified. |