Is toasting contraindicated with cyclosporine (Cyclosporin) therapy?

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Last updated: March 12, 2025View editorial policy

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From the Guidelines

No, toasting (consuming toast) is not contraindicated when taking cyclosporine. Patients on cyclosporine can safely eat toast and other toasted bread products as part of their regular diet. There is no known interaction between the process of toasting bread and the metabolism or effectiveness of cyclosporine, which is an immunosuppressant medication commonly used to prevent organ rejection after transplantation and to treat certain autoimmune conditions. However, patients should be aware that grapefruit juice and some other citrus products can significantly interact with cyclosporine by inhibiting the CYP3A4 enzyme system in the gut, potentially increasing cyclosporine blood levels and the risk of toxicity, as advised by the British Association of Dermatologists guidelines 1.

When taking cyclosporine, patients should maintain consistent timing of medication in relation to meals, take it at the same time each day, and follow their healthcare provider's specific instructions regarding food interactions. Regular blood level monitoring is essential to ensure appropriate cyclosporine dosing. It is also important for patients to avoid grapefruit or grapefruit juice while taking ciclosporin, as recommended by J. Berth-Jones et al. 1.

Key considerations for patients on cyclosporine therapy include:

  • Avoiding grapefruit and grapefruit juice
  • Maintaining consistent medication timing in relation to meals
  • Following healthcare provider instructions regarding food interactions
  • Regular blood level monitoring to ensure appropriate dosing
  • Being aware of potential drug interactions, as outlined in the British National Formulary or the Summary of Product Characteristics 1.

By following these guidelines and being mindful of potential interactions, patients can safely take cyclosporine and minimize the risk of adverse effects.

From the Research

Cyclosporine Therapy and Toasting

There is no direct evidence in the provided studies to suggest that toasting is contraindicated with cyclosporine therapy.

Side Effects of Cyclosporine

  • The studies focus on the side effects of cyclosporine, including its effects on blood pressure 2, renal hemodynamics 3, and nephrotoxicity 4.
  • Cyclosporine has been shown to increase blood pressure in a dose-related fashion 2.
  • It can also cause renal toxicity, including a decrease in glomerular filtration rate 3 and chronic renal damage 4.
  • Other side effects include liver injury 5 and neurotoxicity 6.

Interaction with Food and Drinks

  • There is no mention of toasting or any specific food and drink interactions with cyclosporine in the provided studies.
  • The studies primarily discuss the pharmacological effects and side effects of cyclosporine, without addressing dietary interactions.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Effect of cyclosporine on blood pressure.

The Cochrane database of systematic reviews, 2010

Research

Nephrotoxic aspects of cyclosporine.

Transplantation proceedings, 2004

Research

Liver injury from cyclosporine A.

Digestive diseases and sciences, 1990

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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