Dosing & Uses
Dosage Forms & Strengths
capsule
- 7.9mg
Lupus Nephritis
Indicated in combination with a background immunosuppressive therapy regimen for active lupus nephritis (LN)
23.7 mg PO BID initially; modify dose based on eGFR
Use in combination with mycophenolate mofetil (MMF) and corticosteroids
Consider discontinuation if no therapeutic benefit by 24 weeks
Safety and efficacy not established >1 year; consider risks and benefits of longer durations of treatment in light of treatment response and risk of nephrotoxicity
Dosage Modifications
eGFR dosage adjustments
- If eGFR <60 mL/min/1.73 m2 and reduced from baseline by >20 to <30%: Reduce by 7.9 mg BID; reassess within 2 weeks; if eGFR is still reduced from baseline by >20%, reduce dose again by 7.9 mg BID
- If eGFR <60 mL/min/1.73 m2 and reduced from baseline by ≥30%: Discontinue; reassess within 2 weeks; consider restarting at lower dose (eg, 7.9 mg BID) only if eGFR returns to ≥80% of baseline
- Dose reductions due to eGFR: Consider increasing dose by 7.9 mg BID for each eGFR ≥80% of baseline; do not exceed starting dose
Coadministration of CYP3A4 inhibitors/inducers
- Strong CYP3A4 inhibitors: Contraindicated
- Moderate CYP3A4 inhibitors: Reduce voclosporin to 15.8 mg qAM and 7.9 mg qPM
- Mild CYP3A4 inhibitors: No dosage adjustment necessary
- Strong CYP3A4 inducers: Avoid coadministration
- Avoid any food or drink containing grapefruit
Renal impairment
- Baseline eGFR ≤45 mL/min/1.73 m2: Use not recommended unless benefits outweigh risks; not studied If used in patients with severe renal impairment (eGFR <30 mL/min/1.73 m2) at baseline: Decrease starting dose to 15.8 mg PO BID
- End-stage renal disease with or without hemodialysis: Pharmacokinetics are unknown
Hepatic impairment
- Mild or moderate (Child-Pugh A or B): Reduce to 15.8 mg BID
- Severe (Child-Pugh C): Not recommended
Dosing Considerations
Monitoring parameters
-
Before initiating therapy
- Baseline parameters: eGFR and blood pressure (BP)
- Use not recommended in patients with a baseline eGFR ≤45 mL/min/1.73 m2 unless benefits outweigh risks
- Do not initiate in if BP >165/105 mmHg or with hypertensive emergency
-
During treatment
- eGFR: Every 2 weeks for first month, and every 4 weeks thereafter
- BP: Every 2 weeks for first month, and as clinically indicated thereafter
Limitation of use
- Safety and efficacy not established in combination with cyclophosphamide; use not recommended
Safety and efficacy not established
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (28)
- atazanavir
atazanavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- ceritinib
ceritinib and voclosporin both increase QTc interval. Contraindicated.
- chloramphenicol
chloramphenicol will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- clarithromycin
clarithromycin will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- cobicistat
cobicistat will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- conivaptan
conivaptan will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- darunavir
darunavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- grapefruit
grapefruit will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- idelalisib
idelalisib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- indinavir
indinavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- isoniazid
isoniazid will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- itraconazole
itraconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
itraconazole and voclosporin both increase QTc interval. Contraindicated. - ketoconazole
ketoconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- levoketoconazole
levoketoconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- lonafarnib
lonafarnib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- lopinavir
lopinavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- mifepristone
mifepristone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- nefazodone
nefazodone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- nelfinavir
nelfinavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- nirmatrelvir/ritonavir
nirmatrelvir/ritonavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions. May increase risk of acute and/or chronic nephrotoxicity associated with voclosporin.
- posaconazole
posaconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- ritonavir
ritonavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- rucaparib
rucaparib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- saquinavir
saquinavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- stiripentol
stiripentol will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- tipranavir
tipranavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
- voriconazole
voriconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.
Serious - Use Alternative (73)
- adenovirus types 4 and 7 live, oral
voclosporin decreases effects of adenovirus types 4 and 7 live, oral by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- amisulpride
amisulpride and voclosporin both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amobarbital
amobarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- anagrelide
anagrelide and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- apalutamide
apalutamide will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- armodafinil
armodafinil will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- artemether
artemether and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- axicabtagene ciloleucel
voclosporin, axicabtagene ciloleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- BCG vaccine live
voclosporin decreases effects of BCG vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- bexarotene
bexarotene will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- bosentan
bosentan will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- brexucabtagene autoleucel
voclosporin, brexucabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- brigatinib
brigatinib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- buprenorphine
buprenorphine and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- butabarbital
butabarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- butalbital
butalbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- carbamazepine
carbamazepine will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- chloroquine
chloroquine and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- cholera vaccine
voclosporin decreases effects of cholera vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- ciltacabtagene autoleucel
voclosporin, ciltacabtagene autoleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- clobazam
clobazam will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- dabrafenib
dabrafenib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- dengue vaccine
voclosporin decreases effects of dengue vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- desflurane
desflurane and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- Ebola Zaire vaccine
voclosporin decreases effects of Ebola Zaire vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- efavirenz
efavirenz will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
efavirenz and voclosporin both increase QTc interval. Avoid or Use Alternate Drug. - elagolix
elagolix will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- encorafenib
encorafenib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- enzalutamide
enzalutamide will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- eslicarbazepine acetate
eslicarbazepine acetate will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- etravirine
etravirine will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- idecabtagene vicleucel
voclosporin, idecabtagene vicleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- influenza virus vaccine quadrivalent, intranasal
voclosporin decreases effects of influenza virus vaccine quadrivalent, intranasal by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- isoflurane
isoflurane and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- lisocabtagene maraleucel
voclosporin, lisocabtagene maraleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- lorlatinib
lorlatinib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- lumacaftor/ivacaftor
lumacaftor/ivacaftor will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- measles (rubeola) vaccine
voclosporin decreases effects of measles (rubeola) vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- measles mumps and rubella vaccine, live
voclosporin decreases effects of measles mumps and rubella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- measles, mumps, rubella and varicella vaccine, live
voclosporin decreases effects of measles, mumps, rubella and varicella vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- mitotane
mitotane will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- nafcillin
nafcillin will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- oxaliplatin
oxaliplatin and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- pentobarbital
pentobarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- pexidartinib
pexidartinib will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- phenobarbital
phenobarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- phenytoin
phenytoin will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- poliovirus vaccine live oral trivalent
voclosporin decreases effects of poliovirus vaccine live oral trivalent by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- primidone
primidone will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- rifabutin
rifabutin will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- rifapentine
rifapentine will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- rotavirus oral vaccine, live
voclosporin decreases effects of rotavirus oral vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- rubella vaccine
voclosporin decreases effects of rubella vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- secobarbital
secobarbital will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- sevoflurane
sevoflurane and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
siponimod and voclosporin both increase QTc interval. Avoid or Use Alternate Drug.
- smallpox (vaccinia) and monkeypox vaccine, live, nonreplicating
voclosporin decreases effects of smallpox (vaccinia) vaccine, attenuated by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- smallpox (vaccinia) vaccine, attenuated
voclosporin decreases effects of smallpox (vaccinia) vaccine, attenuated by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- smallpox (vaccinia) vaccine, live
voclosporin decreases effects of smallpox (vaccinia) vaccine, live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- St John's Wort
St John's Wort will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- telotristat ethyl
telotristat ethyl will decrease the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- tisagenlecleucel
voclosporin, tisagenlecleucel. Either increases effects of the other by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug.
- typhoid polysaccharide vaccine
voclosporin decreases effects of typhoid polysaccharide vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- typhoid vaccine live
voclosporin decreases effects of typhoid vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- upadacitinib
voclosporin, upadacitinib. Either increases effects of the other by immunosuppressive effects; risk of infection. Contraindicated.
- varicella virus vaccine live
voclosporin decreases effects of varicella virus vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- yellow fever vaccine
voclosporin decreases effects of yellow fever vaccine by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
- zoster vaccine live
voclosporin decreases effects of zoster vaccine live by immunosuppressive effects; risk of infection. Avoid or Use Alternate Drug. Immunosuppressants also increase risk of infection with concomitant live vaccines. Avoid live vaccines for at least 3 months after immunosuppressants.
Monitor Closely (355)
- adefovir
voclosporin, adefovir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- albuterol
albuterol and voclosporin both increase QTc interval. Use Caution/Monitor.
- aldesleukin
voclosporin, aldesleukin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- alendronate
voclosporin, alendronate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- alfuzosin
voclosporin, alfuzosin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- aliskiren
voclosporin and aliskiren both increase serum potassium. Use Caution/Monitor.
voclosporin, aliskiren. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - amikacin
voclosporin, amikacin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amikacin liposome inhalation
voclosporin, amikacin liposome inhalation. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amiloride
voclosporin and amiloride both increase serum potassium. Use Caution/Monitor.
- aminosalicylic acid
voclosporin, aminosalicylic acid. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amiodarone
amiodarone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, amiodarone. Either increases effects of the other by QTc interval. Use Caution/Monitor. - amitriptyline
voclosporin, amitriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- amoxapine
voclosporin, amoxapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- amphotericin B cholesteryl sulfate
voclosporin, amphotericin B cholesteryl sulfate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amphotericin B deoxycholate
voclosporin, amphotericin B deoxycholate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amphotericin B liposomal
voclosporin, amphotericin B liposomal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- amphotericin B phospholipid complex
voclosporin, amphotericin B phospholipid complex. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- anidulafungin
voclosporin, anidulafungin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- anthrax vaccine adsorbed
voclosporin decreases effects of anthrax vaccine adsorbed by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- apomorphine
voclosporin, apomorphine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- aprepitant
aprepitant will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- arformoterol
voclosporin, arformoterol. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- aripiprazole
aripiprazole and voclosporin both increase QTc interval. Use Caution/Monitor.
- arsenic trioxide
voclosporin, arsenic trioxide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
voclosporin, artemether/lumefantrine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- asenapine
voclosporin, asenapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- asenapine transdermal
voclosporin, asenapine transdermal. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- aspirin
voclosporin, aspirin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- aspirin rectal
voclosporin, aspirin rectal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- atomoxetine
atomoxetine and voclosporin both increase QTc interval. Use Caution/Monitor.
- azilsartan
voclosporin and azilsartan both increase serum potassium. Use Caution/Monitor.
voclosporin, azilsartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - azithromycin
voclosporin, azithromycin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- balsalazide
voclosporin, balsalazide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- bedaquiline
voclosporin, bedaquiline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- benazepril
voclosporin and benazepril both increase serum potassium. Use Caution/Monitor.
voclosporin, benazepril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - berotralstat
berotralstat will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- bicalutamide
bicalutamide will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- bosutinib
bosutinib and voclosporin both increase QTc interval. Use Caution/Monitor.
- canagliflozin
voclosporin and canagliflozin both increase serum potassium. Use Caution/Monitor.
- candesartan
voclosporin and candesartan both increase serum potassium. Use Caution/Monitor.
voclosporin, candesartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - capecitabine
capecitabine and voclosporin both increase QTc interval. Use Caution/Monitor.
- capreomycin
voclosporin, capreomycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- captopril
voclosporin and captopril both increase serum potassium. Use Caution/Monitor.
voclosporin, captopril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - carboplatin
voclosporin, carboplatin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- caspofungin
voclosporin, caspofungin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefaclor
voclosporin, cefaclor. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefadroxil
voclosporin, cefadroxil. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefazolin
voclosporin, cefazolin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefdinir
voclosporin, cefdinir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefditoren
voclosporin, cefditoren. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefixime
voclosporin, cefixime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefotaxime
voclosporin, cefotaxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefotetan
voclosporin, cefotetan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefoxitin
voclosporin, cefoxitin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefpodoxime
voclosporin, cefpodoxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefprozil
voclosporin, cefprozil. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceftazidime
voclosporin, ceftazidime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceftazidime/avibactam
voclosporin, ceftazidime/avibactam. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceftibuten
voclosporin, ceftibuten. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceftizoxime
voclosporin, ceftizoxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceftriaxone
voclosporin, ceftriaxone. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cefuroxime
voclosporin, cefuroxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- celecoxib
voclosporin, celecoxib. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cephalexin
voclosporin, cephalexin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ceritinib
ceritinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- chlorpromazine
voclosporin, chlorpromazine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- choline magnesium trisalicylate
voclosporin, choline magnesium trisalicylate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cidofovir
voclosporin, cidofovir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ciprofloxacin
voclosporin, ciprofloxacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- cisplatin
voclosporin, cisplatin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- citalopram
voclosporin, citalopram. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- clarithromycin
voclosporin, clarithromycin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- clofazimine
voclosporin, clofazimine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- clomipramine
voclosporin, clomipramine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- clonidine
voclosporin will increase the level or effect of clonidine by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Coadministration of voclosporin (a P-gp inhibitor) increases exposure and risk of adverse reactions of P-gp substrates. For certain P-gp substrates with a narrow therapeutic window, refer to prescribing information of these substrates for dosage modifications, if needed.
- clotrimazole
clotrimazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- clozapine
voclosporin, clozapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- colchicine
voclosporin will increase the level or effect of colchicine by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Coadministration of voclosporin (a P-gp inhibitor) increases exposure and risk of adverse reactions of P-gp substrates. For certain P-gp substrates with a narrow therapeutic window, refer to prescribing information of these substrates for dosage modifications, if needed.
- colistin
voclosporin, colistin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- COVID-19 vaccine, adjuvanted-Novavax
voclosporin decreases effects of COVID-19 vaccine, adjuvanted-Novavax by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- COVID-19 vaccine, mRNA-Pfizer
voclosporin decreases effects of COVID-19 vaccine, mRNA-Pfizer by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- COVID-19 vaccine, viral vector-Janssen
voclosporin decreases effects of COVID-19 vaccine, viral vector-Janssen by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- crizotinib
crizotinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, crizotinib. Either increases effects of the other by QTc interval. Use Caution/Monitor. - cyclophosphamide
voclosporin, cyclophosphamide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- cyclosporine
cyclosporine will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin and cyclosporine both increase serum potassium. Use Caution/Monitor. - dasatinib
voclosporin, dasatinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- degarelix
voclosporin, degarelix. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- desipramine
voclosporin, desipramine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- deutetrabenazine
voclosporin, deutetrabenazine. Either increases effects of the other by QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- diatrizoate
voclosporin, diatrizoate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- diatrizoate meglumine/diatrizoate sodium
voclosporin, diatrizoate meglumine/diatrizoate sodium. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- diclofenac
voclosporin, diclofenac. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- diflunisal
voclosporin, diflunisal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- diltiazem
diltiazem will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- disopyramide
voclosporin, disopyramide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- dofetilide
voclosporin, dofetilide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- dolasetron
voclosporin, dolasetron. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- donepezil
donepezil and voclosporin both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and voclosporin both increase QTc interval. Use Caution/Monitor.
- doxycycline
doxycycline will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- dronedarone
dronedarone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, dronedarone. Either increases effects of the other by QTc interval. Use Caution/Monitor. - droperidol
voclosporin, droperidol. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- drospirenone
voclosporin and drospirenone both increase serum potassium. Use Caution/Monitor.
- eliglustat
eliglustat and voclosporin both increase QTc interval. Use Caution/Monitor.
- elvitegravir
voclosporin, elvitegravir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- enalapril
voclosporin and enalapril both increase serum potassium. Use Caution/Monitor.
voclosporin, enalapril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - encorafenib
voclosporin, encorafenib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- entacapone
entacapone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- entrectinib
voclosporin, entrectinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- eplerenone
voclosporin and eplerenone both increase serum potassium. Use Caution/Monitor.
- eprosartan
voclosporin and eprosartan both increase serum potassium. Use Caution/Monitor.
voclosporin, eprosartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - eribulin
voclosporin, eribulin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- erythromycin base
erythromycin base will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, erythromycin base. Either increases effects of the other by QTc interval. Use Caution/Monitor. - erythromycin ethylsuccinate
erythromycin ethylsuccinate will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, erythromycin ethylsuccinate. Either increases effects of the other by QTc interval. Use Caution/Monitor. - erythromycin lactobionate
erythromycin lactobionate will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, erythromycin lactobionate. Either increases effects of the other by QTc interval. Use Caution/Monitor. - erythromycin stearate
erythromycin stearate will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, erythromycin stearate. Either increases effects of the other by QTc interval. Use Caution/Monitor. - escitalopram
voclosporin, escitalopram. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ethiodized oil
voclosporin, ethiodized oil. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- etidronate
voclosporin, etidronate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- etodolac
voclosporin, etodolac. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- everolimus
voclosporin, everolimus. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ezogabine
voclosporin, ezogabine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- fedratinib
fedratinib will increase the level or effect of voclosporin by affecting hepatic enzyme CYP2E1 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- fenoprofen
voclosporin, fenoprofen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- finerenone
voclosporin and finerenone both increase serum potassium. Use Caution/Monitor.
- fingolimod
fingolimod and voclosporin both increase QTc interval. Use Caution/Monitor.
- flecainide
voclosporin, flecainide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- fluconazole
fluconazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, fluconazole. Either increases effects of the other by QTc interval. Use Caution/Monitor.
voclosporin, fluconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - flucytosine
voclosporin, flucytosine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- fluoxetine
voclosporin, fluoxetine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- flurbiprofen
voclosporin, flurbiprofen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- fluvoxamine
fluvoxamine will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- fosamprenavir
fosamprenavir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- fosaprepitant
fosaprepitant will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- foscarnet
voclosporin, foscarnet. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- fosinopril
voclosporin and fosinopril both increase serum potassium. Use Caution/Monitor.
voclosporin, fosinopril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - gadobenate
voclosporin, gadobenate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadobutrol
voclosporin, gadobutrol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadodiamide
voclosporin, gadodiamide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadofosveset
voclosporin, gadofosveset. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadopentetate
voclosporin, gadopentetate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadoterate meglumine
voclosporin, gadoterate meglumine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadoteridol
voclosporin, gadoteridol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadoversetamide
voclosporin, gadoversetamide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gadoxetate
voclosporin, gadoxetate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ganciclovir
voclosporin, ganciclovir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gemifloxacin
gemifloxacin and voclosporin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
voclosporin, gemtuzumab. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- gentamicin
voclosporin, gentamicin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- gilteritinib
gilteritinib and voclosporin both increase QTc interval. Use Caution/Monitor.
- glasdegib
voclosporin, glasdegib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- granisetron
granisetron and voclosporin both increase QTc interval. Use Caution/Monitor.
- griseofulvin
voclosporin, griseofulvin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- haemophilus influenzae type b vaccine
voclosporin decreases effects of haemophilus influenzae type b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- haloperidol
haloperidol will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, haloperidol. Either increases effects of the other by QTc interval. Use Caution/Monitor. - heparin
voclosporin and heparin both increase serum potassium. Use Caution/Monitor.
- hepatitis A vaccine inactivated
voclosporin decreases effects of hepatitis A vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- hepatitis a/b vaccine
voclosporin decreases effects of hepatitis a/b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- hepatitis b vaccine
voclosporin decreases effects of hepatitis b vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- HIV vaccine
voclosporin decreases effects of HIV vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- human papillomavirus vaccine, bivalent
voclosporin decreases effects of human papillomavirus vaccine, bivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- human papillomavirus vaccine, nonavalent
voclosporin decreases effects of human papillomavirus vaccine, nonavalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- human papillomavirus vaccine, quadrivalent
voclosporin decreases effects of human papillomavirus vaccine, quadrivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- hydroxychloroquine sulfate
voclosporin, hydroxychloroquine sulfate. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and voclosporin both increase QTc interval. Use Caution/Monitor.
- ibandronate
voclosporin, ibandronate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ibrexafungerp
voclosporin, ibrexafungerp. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ibuprofen
voclosporin, ibuprofen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ibuprofen IV
voclosporin, ibuprofen IV. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ibuprofen/famotidine
voclosporin, ibuprofen/famotidine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ibutilide
voclosporin, ibutilide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ifosfamide
voclosporin, ifosfamide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- iloperidone
iloperidone will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, iloperidone. Either increases effects of the other by QTc interval. Use Caution/Monitor. - imatinib
imatinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- indacaterol, inhaled
voclosporin, indacaterol, inhaled. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- indapamide
voclosporin, indapamide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- indomethacin
voclosporin, indomethacin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- influenza A (H5N1) vaccine
voclosporin decreases effects of influenza A (H5N1) vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine (H5N1), adjuvanted
voclosporin decreases effects of influenza virus vaccine (H5N1), adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine quadrivalent
voclosporin decreases effects of influenza virus vaccine quadrivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine quadrivalent, adjuvanted
voclosporin decreases effects of influenza virus vaccine quadrivalent, adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine quadrivalent, cell-cultured
voclosporin decreases effects of influenza virus vaccine quadrivalent, cell-cultured by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine quadrivalent, recombinant
voclosporin decreases effects of influenza virus vaccine quadrivalent, recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine trivalent
voclosporin decreases effects of influenza virus vaccine trivalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine trivalent, adjuvanted
voclosporin decreases effects of influenza virus vaccine trivalent, adjuvanted by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- influenza virus vaccine trivalent, recombinant
voclosporin decreases effects of influenza virus vaccine trivalent, recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- inotersen
voclosporin, inotersen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- inotuzumab
voclosporin, inotuzumab. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- iodixanol
voclosporin, iodixanol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ioflupane I 123
voclosporin, ioflupane I 123. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- iohexol
voclosporin, iohexol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- iopamidol
voclosporin, iopamidol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- iopromide
voclosporin, iopromide. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ioversol
voclosporin, ioversol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ioxilan
voclosporin, ioxilan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- irbesartan
voclosporin and irbesartan both increase serum potassium. Use Caution/Monitor.
voclosporin, irbesartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - isradipine
voclosporin, isradipine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- itraconazole
voclosporin, itraconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ivacaftor
ivacaftor will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- Japanese encephalitis virus vaccine
voclosporin decreases effects of Japanese encephalitis virus vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- kanamycin
voclosporin, kanamycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ketoconazole
voclosporin, ketoconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ketoprofen
voclosporin, ketoprofen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ketorolac
voclosporin, ketorolac. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ketorolac intranasal
voclosporin, ketorolac intranasal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- lapatinib
lapatinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, lapatinib. Either increases effects of the other by QTc interval. Use Caution/Monitor. - larotrectinib
larotrectinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- lefamulin
lefamulin will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, lefamulin. Either increases effects of the other by QTc interval. Use Caution/Monitor. - letermovir
letermovir will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, letermovir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - levofloxacin
voclosporin, levofloxacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- levoketoconazole
voclosporin, levoketoconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- lisinopril
voclosporin and lisinopril both increase serum potassium. Use Caution/Monitor.
voclosporin, lisinopril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - lithium
lithium and voclosporin both increase QTc interval. Use Caution/Monitor.
- lofexidine
voclosporin, lofexidine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- lopinavir
voclosporin, lopinavir. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- losartan
voclosporin and losartan both increase serum potassium. Use Caution/Monitor.
voclosporin, losartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - mannitol
voclosporin, mannitol. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- maprotiline
voclosporin, maprotiline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- maribavir
voclosporin, maribavir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- meclofenamate
voclosporin, meclofenamate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- mefenamic acid
voclosporin, mefenamic acid. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- mefloquine
voclosporin, mefloquine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- meloxicam
voclosporin, meloxicam. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- melphalan
voclosporin, melphalan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine
voclosporin decreases effects of meningococcal A C Y and W polysaccharide tetanus toxoid conjugate vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- meningococcal A C Y and W-135 diphtheria conjugate vaccine
voclosporin decreases effects of meningococcal A C Y and W-135 diphtheria conjugate vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- meningococcal A C Y and W-135 polysaccharide vaccine combined
voclosporin decreases effects of meningococcal A C Y and W-135 polysaccharide vaccine combined by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- meningococcal C and Y/haemophilus influenza type B vaccine
voclosporin decreases effects of meningococcal C and Y/haemophilus influenza type B vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- meningococcal group B vaccine
voclosporin decreases effects of meningococcal group B vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- mesalamine
voclosporin, mesalamine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- mesalamine rectal
voclosporin, mesalamine rectal. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- methadone
voclosporin, methadone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- methotrexate
voclosporin, methotrexate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- metronidazole
metronidazole will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- micafungin
voclosporin, micafungin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- mifepristone
voclosporin, mifepristone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- mirtazapine
mirtazapine and voclosporin both increase QTc interval. Use Caution/Monitor.
- moexipril
voclosporin and moexipril both increase serum potassium. Use Caution/Monitor.
voclosporin, moexipril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - moxifloxacin
voclosporin, moxifloxacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- nabumetone
voclosporin, nabumetone. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- naproxen
voclosporin, naproxen. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- neomycin PO
voclosporin, neomycin PO. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- netupitant/palonosetron
netupitant/palonosetron will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- nilotinib
voclosporin, nilotinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- nortriptyline
voclosporin, nortriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- nystatin
voclosporin, nystatin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- octreotide
voclosporin, octreotide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ofloxacin
voclosporin, ofloxacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- olanzapine
voclosporin, olanzapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- olmesartan
voclosporin and olmesartan both increase serum potassium. Use Caution/Monitor.
voclosporin, olmesartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - olsalazine
voclosporin, olsalazine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ondansetron
voclosporin, ondansetron. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- osilodrostat
voclosporin, osilodrostat. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- osimertinib
voclosporin, osimertinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- oteseconazole
voclosporin, oteseconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- oxaprozin
voclosporin, oxaprozin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- ozanimod
voclosporin, ozanimod. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- paliperidone
voclosporin, paliperidone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- panobinostat
voclosporin, panobinostat. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- pasireotide
voclosporin, pasireotide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- pazopanib
voclosporin, pazopanib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- pentamidine
voclosporin and pentamidine both increase serum potassium. Use Caution/Monitor.
voclosporin, pentamidine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
voclosporin, pentamidine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - perindopril
voclosporin and perindopril both increase serum potassium. Use Caution/Monitor.
voclosporin, perindopril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - pimavanserin
voclosporin, pimavanserin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- pimozide
voclosporin, pimozide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- piroxicam
voclosporin, piroxicam. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- pitolisant
voclosporin, pitolisant. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- plazomicin
voclosporin, plazomicin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- pneumococcal vaccine 13-valent
voclosporin decreases effects of pneumococcal vaccine 13-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- pneumococcal vaccine 15-valent
voclosporin decreases effects of pneumococcal vaccine 15-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- pneumococcal vaccine 20-valent
voclosporin decreases effects of pneumococcal vaccine 20-valent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- pneumococcal vaccine heptavalent
voclosporin decreases effects of pneumococcal vaccine heptavalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- pneumococcal vaccine polyvalent
voclosporin decreases effects of pneumococcal vaccine polyvalent by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- poliovirus vaccine inactivated
voclosporin decreases effects of poliovirus vaccine inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- polymyxin B
voclosporin, polymyxin B. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- posaconazole
voclosporin, posaconazole. Either increases effects of the other by QTc interval. Use Caution/Monitor.
voclosporin, posaconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - potassium acid phosphate
voclosporin and potassium acid phosphate both increase serum potassium. Use Caution/Monitor.
- potassium chloride
voclosporin and potassium chloride both increase serum potassium. Use Caution/Monitor.
- potassium citrate
voclosporin and potassium citrate both increase serum potassium. Use Caution/Monitor.
- potassium citrate/citric acid
voclosporin and potassium citrate/citric acid both increase serum potassium. Use Caution/Monitor.
- potassium phosphates, IV
voclosporin and potassium phosphates, IV both increase serum potassium. Use Caution/Monitor.
- primaquine
primaquine and voclosporin both increase QTc interval. Use Caution/Monitor.
- procainamide
voclosporin, procainamide. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- protriptyline
voclosporin, protriptyline. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- quetiapine
voclosporin, quetiapine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- quinapril
voclosporin and quinapril both increase serum potassium. Use Caution/Monitor.
voclosporin, quinapril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - quinidine
voclosporin, quinidine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- quinine
voclosporin, quinine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- rabies vaccine
voclosporin decreases effects of rabies vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- rabies vaccine chick embryo cell derived
voclosporin decreases effects of rabies vaccine chick embryo cell derived by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- ramipril
voclosporin and ramipril both increase serum potassium. Use Caution/Monitor.
voclosporin, ramipril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - ranolazine
voclosporin, ranolazine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ribociclib
ribociclib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, ribociclib. Either increases effects of the other by QTc interval. Use Caution/Monitor. - rilpivirine
voclosporin, rilpivirine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- risedronate
voclosporin, risedronate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- risperidone
voclosporin, risperidone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ritonavir
voclosporin, ritonavir. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- romidepsin
voclosporin, romidepsin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- sacubitril/valsartan
voclosporin and sacubitril/valsartan both increase serum potassium. Use Caution/Monitor.
voclosporin, sacubitril/valsartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - salsalate
voclosporin, salsalate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- saquinavir
voclosporin, saquinavir. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- SARS-CoV-2 vaccine, inactivated
voclosporin decreases effects of SARS-CoV-2 vaccine, inactivated by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- schisandra
schisandra will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- selpercatinib
voclosporin, selpercatinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- sertraline
sertraline will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
voclosporin, sertraline. Either increases effects of the other by QTc interval. Use Caution/Monitor. - sirolimus
voclosporin will increase the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Coadministration of voclosporin (a P-gp inhibitor) increases exposure and risk of adverse reactions of P-gp substrates. For certain P-gp substrates with a narrow therapeutic window, refer to prescribing information of these substrates for dosage modifications, if needed.
- sodium phosphates, IV
voclosporin, sodium phosphates, IV. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- solifenacin
voclosporin, solifenacin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- sorafenib
voclosporin, sorafenib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- sotalol
voclosporin, sotalol. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- spironolactone
voclosporin and spironolactone both increase serum potassium. Use Caution/Monitor.
- streptomycin
voclosporin, streptomycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- streptozocin
voclosporin, streptozocin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- succinylcholine
voclosporin and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfadiazine
voclosporin, sulfadiazine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- sulfasalazine
voclosporin, sulfasalazine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- sulfisoxazole
voclosporin, sulfisoxazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- sulindac
voclosporin, sulindac. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- sunitinib
voclosporin, sunitinib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- tacrolimus
voclosporin and tacrolimus both increase serum potassium. Use Caution/Monitor.
voclosporin, tacrolimus. Either increases effects of the other by QTc interval. Use Caution/Monitor. - telavancin
voclosporin, telavancin. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- telmisartan
voclosporin and telmisartan both increase serum potassium. Use Caution/Monitor.
voclosporin, telmisartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - temsirolimus
voclosporin will increase the level or effect of temsirolimus by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Coadministration of voclosporin (a P-gp inhibitor) increases exposure and risk of adverse reactions of P-gp substrates. For certain P-gp substrates with a narrow therapeutic window, refer to prescribing information of these substrates for dosage modifications, if needed.
- tenofovir AF
voclosporin, tenofovir AF. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- tenofovir DF
voclosporin, tenofovir DF. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- terbinafine
voclosporin, terbinafine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- tetanus toxoid adsorbed or fluid
voclosporin decreases effects of tetanus toxoid adsorbed or fluid by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- tetrabenazine
voclosporin, tetrabenazine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- tetracycline
tetracycline will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- thioridazine
voclosporin, thioridazine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- thiothixene
voclosporin, thiothixene. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- tick-borne encephalitis vaccine
voclosporin decreases effects of tick-borne encephalitis vaccine by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
- tiludronate
voclosporin, tiludronate. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- tobramycin
voclosporin, tobramycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- tobramycin inhaled
voclosporin, tobramycin inhaled. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- tolmetin
voclosporin, tolmetin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- trandolapril
voclosporin and trandolapril both increase serum potassium. Use Caution/Monitor.
voclosporin, trandolapril. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - triamterene
voclosporin and triamterene both increase serum potassium. Use Caution/Monitor.
- trimethoprim
voclosporin and trimethoprim both decrease serum potassium. Use Caution/Monitor.
- trimipramine
voclosporin, trimipramine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- ublituximab
ublituximab and voclosporin both increase immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Owing to potential additive immunosuppressive effects, consider duration of effect and mechanism of action of these therapies if coadministered
- umeclidinium bromide/vilanterol inhaled
voclosporin, umeclidinium bromide/vilanterol inhaled. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- valganciclovir
voclosporin, valganciclovir. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- valsartan
voclosporin and valsartan both increase serum potassium. Use Caution/Monitor.
voclosporin, valsartan. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - vancomycin
voclosporin, vancomycin. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- vandetanib
voclosporin, vandetanib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- vardenafil
voclosporin, vardenafil. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- vemurafenib
voclosporin, vemurafenib. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- verapamil
verapamil will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- voriconazole
voclosporin, voriconazole. Either increases effects of the other by QTc interval. Use Caution/Monitor.
voclosporin, voriconazole. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity. - vorinostat
voclosporin, vorinostat. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voxelotor
voxelotor will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- ziprasidone
voclosporin, ziprasidone. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- zoledronic acid
voclosporin, zoledronic acid. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- zoster vaccine recombinant
voclosporin decreases effects of zoster vaccine recombinant by immunosuppressive effects; risk of infection. Modify Therapy/Monitor Closely. Inactivated vaccines noted to be safe for administration may not be sufficiently immunogenic during treatment.
Minor (30)
- ambrisentan
voclosporin will increase the level or effect of ambrisentan by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- atorvastatin
voclosporin will increase the level or effect of atorvastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- bosentan
voclosporin will increase the level or effect of bosentan by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- caspofungin
voclosporin will increase the level or effect of caspofungin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- elagolix
voclosporin will increase the level or effect of elagolix by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- elbasvir/grazoprevir
voclosporin will increase the level or effect of elbasvir/grazoprevir by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- eluxadoline
voclosporin will increase the level or effect of eluxadoline by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- enalapril
voclosporin will increase the level or effect of enalapril by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- ezetimibe
voclosporin will increase the level or effect of ezetimibe by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- fexofenadine
voclosporin will increase the level or effect of fexofenadine by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- fluvastatin
voclosporin will increase the level or effect of fluvastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- fostamatinib
fostamatinib will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- glecaprevir/pibrentasvir
voclosporin will increase the level or effect of glecaprevir/pibrentasvir by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- glyburide
voclosporin will increase the level or effect of glyburide by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- letermovir
voclosporin will increase the level or effect of letermovir by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- lovastatin
voclosporin will increase the level or effect of lovastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- methotrexate
voclosporin will increase the level or effect of methotrexate by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- olmesartan
voclosporin will increase the level or effect of olmesartan by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- ombitasvir/paritaprevir/ritonavir
voclosporin will increase the level or effect of ombitasvir/paritaprevir/ritonavir by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)
voclosporin will increase the level or effect of ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- pitavastatin
voclosporin will increase the level or effect of pitavastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- pravastatin
voclosporin will increase the level or effect of pravastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- quinupristin/dalfopristin
quinupristin/dalfopristin will increase the level or effect of voclosporin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Reduce voclosporin daily dosage to 15.8 mg PO in AM and 7.9 mg PO in PM.
- repaglinide
voclosporin will increase the level or effect of repaglinide by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- rifamycin
voclosporin will increase the level or effect of rifamycin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- rosuvastatin
voclosporin will increase the level or effect of rosuvastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- simvastatin
voclosporin will increase the level or effect of simvastatin by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- troglitazone
voclosporin will increase the level or effect of troglitazone by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- valsartan
voclosporin will increase the level or effect of valsartan by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
- voxilaprevir
voclosporin will increase the level or effect of voxilaprevir by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.
Adverse Effects
>10%
Glomerular filtration rate decreased (26%)
Hypertension (19%)
Diarrhea (19%)
Headache (15%)
Anemia (12%)
Cough (11%)
1-10%
Urinary tract infection (10%)
Upper abdominal pain (7%)
Dyspepsia (6%)
Alopecia (6%)
Renal Impairment (6%)
Abdominal pain (5%)
Mouth ulceration (4%)
Fatigue (4%)
Tremor (3%)
Acute kidney injury (3%)
Decreased appetite (3%)
Gingivitis (<3%)
Hypertrichosis (<3%)
Frequency Not Defined
Upper respiratory tract infections (bacterial and viral)
Herpes zoster
Pneumonia
Gastroenteritis
Urinary tract infections
Cytomegalovirus chorioretinitis
Cytomegalovirus infection
Herpes zoster cutaneous disseminated
Blood creatinine increased
Azotemia
Renal failure
Oliguria
Proteinuria
Hyperkalemia
QT prolongation
Warnings
Black Box Warnings
Malignancies and serious infections
- Increased risk for developing malignancies and serious infections with voclosporin or other immunosuppressants that may lead to hospitalization or death
Contraindications
Coadministration of strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin)
Serious or severe hypersensitivity reactions to voclosporin or any of its excipients
Cautions
Hypertension is a common adverse reaction and may require antihypertensive therapy; monitor relevant drug interactions
May cause a spectrum of neurotoxicities, which may include posterior reversible encephalopathy syndrome, delirium, seizure, coma, tremors, paresthesia, headache, mental status changes, and changes in motor and sensory functions; monitor for neurologic abnormalities; reduce dosage or discontinue therapy
Hyperkalemia reported with calcineurin inhibitors; risk may be increased if coadministered with other agents associated with hyperkalemia (eg, potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers); monitor serum potassium levels
Cases of pure red cell aplasia (PRCA) reported in patients treated with another calcineurin-inhibitor immunosuppressant; reported risk factors were parvovirus B19 infection, underlying disease, or concomitant medications associated with PRCA; if diagnosed, consider discontinuation
Lymphoma and other malignancies
- Immunosuppressants, including voclosporin, increase risk of developing lymphomas and other malignancies, particularly of the skin
- Risk may be related to intensity and duration of immunosuppression
- Examine for skin changes
- Avoid or limit sun exposure and avoid artificial UV light (tanning beds, sun lamps) by wearing protective clothing and using a broad-spectrum sunscreen with a high protection factor (SPF ≥30)
Serious infections
- Immunosuppressants, including voclosporin, increase the risk of developing bacterial, viral, fungal, and protozoal infections, including opportunistic infections
- Infections may lead to serious, including fatal, outcomes
- Viral infections reported include cytomegalovirus and herpes zoster infections
- Monitor for any developing infection
- Consider benefits and risks; use the lowest effective dose needed to maintain response
Nephrotoxicity
- Nephrotoxicity reported; may cause acute and/or chronic nephrotoxicity
- Monitor renal function; consider dosage reduction or discontinuation at baseline
- Safety and efficacy not established >1 year; consider risks and benefits of longer durations of treatment in light of treatment response and risk of nephrotoxicity
- Concomitant nephrotoxic drugs may increase risk of nephrotoxicity
Drug interaction overview
- Sensitive CYP3A4 substrate; P-gp inhibitor; OATP1B1 inhibitor
-
CYP3A4 inhibitors
- Coadministration with strong or moderate CYP3A4 inhibitors increases voclosporin effects and risk of adverse reactions
- Use contraindicated for strong CYP3A4 inhibitors; reduce voclosporin dose for moderate CYP3A4 inhibitors; avoid food or drink containing grapefruit during treatment
-
CYP3A4 inducers
- Coadministration with strong or moderate CYP3A4 inducers decreases voclosporin effects and efficacy
- Avoid coadministration of strong and moderate CYP3A4 inducers
-
P-gp substrates
- Coadministration of voclosporin increases effects and risk of adverse reactions of P-gp substrates; reduce dose of P-gp substrates with a narrow therapeutic window, if needed
-
OATP1B substrates
- Effects on OATP1B1 substrates (eg, statins) has not been studied clinically; information suggests voclosporin may increase concentration of OATP1B1 substrates; monitor for adverse reactions of OATP1B1 substrates when concomitantly used
-
Vaccines
- Live attenuated vaccines during treatment: Avoid use
- Inactivated vaccines: Noted safe for administration; however, may not be sufficiently immunogenic during treatment
-
QT prolongation
- Prolongs QTc interval in a dose-dependent manner after single-dose administration at a dose higher than the recommended therapeutic dose
- Use in combination with other drugs that are known to prolong QTc may result in clinically significant QT prolongation
- Consider obtaining electrocardiograms and monitoring electrolytes in patients at high risk
Pregnancy & Lactation
Pregnancy
Avoid use in pregnant females; formulation contains alcohol (21.6 mg of dehydrated ethanol per capsule for a dose of 129.4 mg/day); studies have demonstrated that alcohol is associated with fetal harm (eg, central nervous system abnormalities, behavioral disorders, impaired intellectual development)
Insufficient data available on use in pregnant females to determine drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes
May be used in combination with a immunosuppressive therapy regimen that includes MMF; information for MMF regarding pregnancy, pregnancy testing, contraception, and infertility also applies to this combination regimen; refer to MMF prescribing information for more information
There are risks (eg, worsening of the underlying disease, premature birth, miscarriage, intrauterine growth restriction) to mother and fetus associated with systemic lupus erythematosus
Animal data
- Oral administration of either voclosporin or a 50:50 mixture of voclosporin and its cis-isomer was embryocidal and feticidal in rats and rabbits at doses 15x and 1x, respectively, the maximum recommended human dose (MRHD) of 23.7 mg BID, based on drug exposure AUC
- Reduced placental and fetal body weights occurred in rabbits at 0.1x-0.3x the MRHD and in rats at higher drug exposures
- Crosses the placenta in pregnant rats
- Dystocia was evident in a prenatal and postnatal study in rats
Lactation
No available data on presence in human milk, effects on breastfed infants, or effects on milk production
Present in milk of lactating rats; therefore, drug is likely to be present in human milk
Breastfeeding is not recommended during treatment and for at least 7 days after last dose (~6 elimination half-lives)
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Calcineurin-inhibitor immunosuppressant
Mechanism of voclosporin suppression of calcineurin has not been fully established
Activation of lymphocytes involves an increase in intracellular calcium concentrations that bind to calcineurin regulatory site and activate calmodulin binding catalytic subunit and through dephosphorylation activates the transcription factor, Nuclear Factor of Activated T-Cell Cytoplasmic
Immunosuppressant activity results in inhibition of lymphocyte proliferation, T-cell cytokine production, and expression of T-cell activation surface antigens
Absorption
Peak plasma time: 1.5 hr (empty stomach)
Steady-state reached at 6 days
Effects of food
- Coadministration with either low- or high-fat meals decreased both rate and extent of absorption
- Plasma concentration and AUC of voclosporin were reduced by 29% to 53% and 15% to 25%
Distribution
Vd (steady-state): 2,154 L
Protein bound: 97%
Metabolism
Predominately metabolized by CYP3A4
Metabolite in human whole blood represented 16.7% of total exposure and is about 8-fold less potent than parent molecule
Elimination
Clearance (steady-state): 63.6 L/hr
Half-life: ~30 hr
Excretion (single 70-mg dose): Feces (92.7% [5% unchanged]); urine (2.1% [0.25% unchanged])
Administration
Oral Administration
Swallow capsule whole on an empty stomach
Do not open, crush, or divide capsule
Administer at a consistent 12-hr schedule as close as possible and with at least 8 hr between doses
Avoid eating grapefruit or drinking grapefruit juice
Missed dose
- ≤4 hr after missed dose: Take as soon as possible
- >4 hr after missed dose: Wait until next scheduled dose; do NOT double dose
Storage
Store at room temperature (20-25ºC [68-77ºF]); excursions permitted to 15-30ºC (59- 86ºF)
Do not put in another container
Keep in original packaging until ready to be taken
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