Increased blood levels w/ CYP3A4 inhibitors (eg, ketoconazole, fluconazole, itraconazole, voriconazole, erythromycin, HIV PIs; clotrimazole, clarithromycin, josamycin, nifedipine, nicardipine, diltiazem, verapamil, danazol, ethinylestradiol, omeprazole, nefazodone. Potential metabolism inhibition w/ bromocriptine, cortisone, dapsone, ergotamine, gestodene, lidocaine, mephenytoin, miconazole, midazolam, nilvadipine, norethindrone, quinidine, tamoxifen, (triacetyl)oleandomycin; grapefruit juice; lansoprazol, ciclosporin. Potentially increase blood levels w/ NSAIDs, oral anticoagulants/antidiabetics; prokinetic agents (eg, metoclopramide & cisapride), cimetidine & Mg-Al hydroxide. Decreased blood levels w/ CYP3A4 inducers (eg, rifampicin, phenytoin, St. John's wort, phenobarb, corticosteroids; carbamazepine, metamizole & INH). Increased or decreased blood levels w/ high-dose prednisolone or methylprednisolone for the treatment of acute rejection. Prolonged t½
of ciclosporin; increased blood level of phenytoin; reduced clearance of steroid-based contraceptives. May potentially decrease clearance & increase t½
of pentobarbital & antipyrine. Increased nephrotoxic or neurotoxic effects w/ aminoglycosides, gyrase inhibitors, vancomycin, co-trimoxazole, NSAIDs, ganciclovir or acyclovir. Enhanced nephrotoxicity w/ amphotericin B & ibuprofen. Risk of hyperkalemia w/ high K intake or K-sparing diuretics (eg, amiloride, triamterene or spironolactone). Avoid administration of live attenuated vaccines. Enhanced visual & neurological disturbances w/ alcohol.