Ciclosporin

For an informed discussion with your doctor or pharmacist. This information collection is not a clinically validated interaction checker. Missing data do not establish safety. Do not change or stop prescribed medicines on the basis of this information. The findings apply to the specific conditions studied; laboratory and animal studies cannot be directly extrapolated to humans.

Active substance: Ciclosporin

Examples of brand names: Sandimmun [DE]

ATC code: L04AD01

Main use (for orientation): Transplant medicine; autoimmune diseases

Documented research summary

Preclinical inhibition and limited clinical signals have been reported. One small series reported stable concentrations; a later case report described an interaction, but the available abstract provides no reliable direction or effect size.

Uncertainties and limitations

The full text of the 2024 case report remains outstanding for the direction and magnitude of the effect; nephrotoxicity increases clinical relevance despite weak pair-specific evidence.

Research is limited to the specified date and protocol; it is not globally exhaustive. Brand names and authorisations do not constitute a complete current market overview.

Structured assessment

Category: Direct pair finding

Cannabinoid scope: 28 register names in the documented search family; neither 28 individual clinical trials nor a blanket assessment of all cannabinoids.

Evidence status: Pair-specific evidence, distinguished in the individual findings

Mechanism / drug context: CBD inhibits ciclosporin metabolism in the laboratory; clinical data are limited and heterogeneous.

Type of supporting material: See the separate original findings

Clinical interpretation: Requires individual assessment by a doctor or pharmacist. Lack of evidence does not establish safety; no dosage or discontinuation advice is provided.

Context: Ciclosporin / cyclosporine, an active calcineurin inhibitor; modified oral capsules, not automatically bioequivalent to Sandimmune.

Drug context and gaps in search results are not measured interactions. The source role below describes which statement the source actually supports.

Source role [CA_L_D0020]: Drug context

Statement supported: Supports dosage form, metabolism and/or known risks; alone, it does not substantiate a cannabinoid–drug pair finding.

Source: CYCLOSPORINE, MODFIED (CYCLOSPORINE) CAPSULE, LIQUID FILLED [APOTEX CORP.] [CA_L_D0020]

Source role [CA_P_8730919]: Pair finding

Statement supported: Reduced formation of ciclosporin metabolites.

Source: Inhibition of cyclosporine and tetrahydrocannabinol metabolism by cannabidiol in mouse and human microsomes. [CA_P_8730919]

Source role [CA_P_29579828]: Pair finding

Statement supported: Ciclosporin concentrations remained stable in a small transplant series.

Source: Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay. [CA_P_29579828]

Source role [CA_P_38212169]: Pair finding

Statement supported: One case reports an interaction with ciclosporin and mycophenolate mofetil.

Source: Drug-Drug Interaction Between Cannabidiol, Cyclosporine, and Mycophenolate Mofetil: A Case Report. [CA_P_38212169]

Scope of review: Individual research with documented title/abstract screening and targeted review of original sections. This is not exhaustive evidence that interactions are absent.

Unresolved source question: The complete stored individual review, label review, literature screening, conclusion and uncertainties were read. Targeted sections of original information were rechecked; no claim is made that all product information or full texts were completely revalidated.

Separately recorded findings

3 separately recorded findings. Each statement applies to its documented study context.

CBD – laboratory and animal studies

Finding ID: V6_D0020_1

Type of result: Finding within the documented study context

Observation: Reduced formation of ciclosporin metabolites.

Mechanism: Inhibition of oxidative metabolism

Study type: Human / mouse microsomes and a mouse experiment

Context studied: Jaeger et al. 1996.

Clinical interpretation: No clinical effect size.

Limitations and uncertainties: Human microsomes are not treated human participants; extrapolation of exposure remains unresolved.

Original sources for this finding: Inhibition of cyclosporine and tetrahydrocannabinol metabolism by cannabidiol in mouse and human microsomes. [CA_P_8730919]

CBD – clinical signals

Finding ID: V6_D0020_2

Type of result: No clear additional signal under the conditions studied

Observation: Ciclosporin concentrations remained stable in a small transplant series.

Mechanism: Mechanism not determined

Study type: Uncontrolled case series

Context studied: Seven people in total, not all receiving ciclosporin.

Clinical interpretation: Does not establish general freedom from interactions.

Limitations and uncertainties: Small and heterogeneous; not a randomised pharmacokinetic study.

Original sources for this finding: Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay. [CA_P_29579828]

CBD – clinical signals

Finding ID: V6_D0020_3

Type of result: Finding within the documented study context

Observation: One case reports an interaction with ciclosporin and mycophenolate mofetil.

Mechanism: Pharmacokinetic interaction reported, mechanism not established

Study type: Case report; abstract

Context studied: Cuñetti et al. 2024.

Clinical interpretation: Immunosuppression potentially affected.

Limitations and uncertainties: Abstract provides no reliable direction or magnitude; clarification from the full text remains outstanding.

Original sources for this finding: Drug-Drug Interaction Between Cannabidiol, Cyclosporine, and Mycophenolate Mofetil: A Case Report. [CA_P_38212169]

References and access status

[CA_L_D0020] CYCLOSPORINE, MODFIED (CYCLOSPORINE) CAPSULE, LIQUID FILLED [APOTEX CORP.]

Original source / bibliographic reference

Authors: Apotex Corp.

Year: 2026

Source type: Current published human-use SPL / product information

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

[CA_P_38212169] Drug-Drug Interaction Between Cannabidiol, Cyclosporine, and Mycophenolate Mofetil: A Case Report.

Original source / bibliographic reference

Authors: Cuñetti L, Oricchio F, Vázquez M, Peyraube R, Manzo L, Nalerio C, Curi L, Maldonado C.

Year: 2024

Source type: Journal Article; Case Reports

DOI: 10.1016/j.transproceed.2023.11.013

PMID: 38212169

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_29579828] Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay.

Original source / bibliographic reference

Authors: Cuñetti L, Manzo L, Peyraube R, Arnaiz J, Curi L, Orihuela S.

Year: 2018

Source type: Clinical Trial; Journal Article

DOI: 10.1016/j.transproceed.2017.12.042

PMID: 29579828

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

[CA_P_8730919] Inhibition of cyclosporine and tetrahydrocannabinol metabolism by cannabidiol in mouse and human microsomes.

Original source / bibliographic reference

Authors: Jaeger W, Benet LZ, Bornheim LM.

Year: 1996

Source type: Research Support, U.S. Gov't, P.H.S.; Journal Article

DOI: 10.3109/00498259609046707

PMID: 8730919

Source access – 23 October 2026: Source destination was accessible when checked.

Bibliographic attribution or source identity cross-checked.

DOI – publisher access (access restrictions may apply)

Research as of 23 October 2026. Not all original full texts could be reviewed in full. Source accessibility and the strength of scientific evidence must be assessed separately. An accessible link does not establish medical approval; a bibliographic record with an abstract does not replace the original full text.

Drug search and explanation of the evidence · Guide: cannabinoids and medicines · Author and responsibility