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Sandimmune oral


This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Orlistat decreases the amount of cyclosporine that your body absorbs.

What might happen:

The level of cyclosporine in your blood may decrease, making it less effective. This may increase the risk of your organ transplant failing.

What you should do about this interaction:

It is important to take orlistat at least 3 hours before or after your cyclosporine dose. Tell your healthcare professionals (e.g. doctor or pharmacist) that you are taking these medicines together. Your doctor may want to check your cyclosporine levels more often while you are taking them together.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.


1.Xenical (orlistat) US prescribing information. Roche Laboratories, Inc. October, 2013.
2.Nagele H, Petersen B, Bonacker U, Rodiger W. Effect of orlistat on blood cyclosporin concentration in an obese heart transplant patient. Eur J Clin Pharmacol 1999 Nov;55(9):667-9.
3.Evans S, Michael R, Wells H, Maclean D, Gordon I, Taylor J, Goldsmith D. Drug interaction in a renal transplant patient: cyclosporin-Neoral and orlistat. Am J Kidney Dis 2003 Feb;41(2):493-6.
4.Barbaro D, Orsini P, Pallini S, Piazza F, Pasquini C. Obesity in transplant patients: case report showing interference of orlistat with absorption of cyclosporine and review of literature. Endocr Pract 2002 Mar-Apr;8(2):124-6.
5.Colman E, Fossler M. Reduction in blood cyclosporine concentrations by orlistat. N Engl J Med 2000 Apr 13;342(15):1141-2.
6.Errasti P, Garcia I, Lavilla J, Ballester B, Manrique J, Purroy A. Reduction in blood cyclosporine concentration by orlistat in two renal transplant patients. Transplant Proc 2002 Feb;34(1):137-9.
7.Le Beller C, Bezie Y, Chabatte C, Guillemain R, Amrein C, Billaud EM. Co-administration of orlistat and cyclosporine in a heart transplant recipient. Transplantation 2000 Nov 27;70(10):1541-2.
8.Schnetzler B, Kondo-Oestreicher M, Vala D, Khatchatourian G, Faidutti B. Orlistat decreases the plasma level of cyclosporine and may be responsible for the development of acute rejection episodes. Transplantation 2000 Nov 27;70(10):1540-1.
9.Zhi J, Moore R, Kanitra L, Mulligan TE. Pharmacokinetic evaluation of the possible interaction between selected concomitant medications and orlistat at steady state in healthy subjects. J Clin Pharmacol 2002 Sep; 42(9):1011-9.

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