Table 7.
- Major drug-drug interactions involving immunosuppressive agents.
| Antimicrobials | Calcineurin inhibitors | Mammalian target of rapamycin inhibitors | Mycophenolate |
|---|---|---|---|
| Fluoroquinolones (primarily ofloxacin > ciprofloxacin) | Increased levels | - | - |
| Macrolides (erythromycin > clarithromycin > azithromycin) | Markedly increased levels | Markedly increased levels | - |
| Rifamycins (rifampin > rifabutin) | Markedly decreased levels | Markedly decreased levels | - |
| Linezolid | Increased myelosuppression | Increased myelosuppression and platelet decrease | |
| Triazoles (ketoconazole / voriconazole / posaconazole > itraconazole / fluconazole) | Increased levels | Increased levels (voriconazole contraindicated) | - |
| Ganciclovir / valganciclovir | Increased myelosuppression | Increased myelosuppression |