Possible Interaction: Cyclosporine and Epinephrine

“The addition of CyA , at therapeutic concentrations to platelet rich plasma from normal subjects in vitro was found to increase aggregation in response to adrenaline , collagen and ADP.”

“There was a negative correlation between cyclosporine level and platelet aggregation values induced by ADP (r = -0.43, p < 0.01), ristocetin (r = -0.40, p < 0.05), epinephrine (r = -0.41, p < 0.05), and collagen (r = -0.43, p < 0.01).”

“Platelet aggregation values induced by ADP, epinephrine , ristocetin, and collagen were lower in cyclosporine-treated patients than tacrolimus-treated patients, hypertensive subjects, and healthy subjects, though the difference was not statistically significant (p > 0.05).”

“The purpose of this study was (1) to confirm that CsA enhances platelet sensitivity to the soluble agonists, adenosine diphosphate (ADP) and epinephrine (EPI), and (2) to determine if this enhancement is mediated by alteration in the availability of platelet surface fibrinogen receptors, a final mediator of platelet activation.”

“Norepinephrine and epinephrine levels in the adrenal medulla and plasma of cyclosporine-treated rats were also significantly higher than levels in the control rats.”

“Blood pressure studies revealed that CsA exerts a competitive, reversible antagonism against norepinephrine, epinephrine , and phenylephrine.”

“Treatment with CsA for 7 days resulted in marginal increases in renal NE (22%) and EPI (30%).”

“Treatment with CsA increased renal NE and EPI levels by 59% and 70% respectively within 1 hour.”