Table 7

- Major drug-drug interactions involving immunosuppressive agents.

AntimicrobialsCalcineurin inhibitorsMammalian target of rapamycin inhibitorsMycophenolate
Fluoroquinolones (primarily ofloxacin > ciprofloxacin)Increased levels--
Macrolides (erythromycin > clarithromycin > azithromycin)Markedly increased levelsMarkedly increased levels-
Rifamycins (rifampin > rifabutin)Markedly decreased levelsMarkedly decreased levels-
Linezolid Increased myelosuppressionIncreased myelosuppression and platelet decrease
Triazoles (ketoconazole / voriconazole / posaconazole > itraconazole / fluconazole)Increased levelsIncreased levels (voriconazole contraindicated)-
Ganciclovir / valganciclovir Increased myelosuppressionIncreased myelosuppression