Immunosuppressant Comparison: Cyclosporine vs Tacrolimus vs Mycophenolate — Transplant Drug Monitoring
All three drugs prevent organ rejection, but the NCLEX expects you to match the right adverse effect to the right drug. Picking "nephrotoxicity" for mycophenolate or "myelosuppression" for cyclosporine loses you the question — and in practice, means you miss the lab value that signals toxicity.
Master this comparison — play it or drill it.
Practice 40 NCLEX-style questions
Practice nowComparison
- Calcineurin inhibitor
- Binds cyclophilin, ↓ IL-2
- Calcineurin inhibitor
- Binds FKBP; more potent
- Antimetabolite: ↓ purine synthesis
- Transplant rejection prophylaxis
- Transplant rejection prophylaxis
- Transplant rejection prophylaxis
- PO/IV
- PO/IV
- PO/IV
- Give on an empty stomach
- Monitor for signs of infection
- Renal function (nephrotoxic)
- Monitor for signs of infection
- Renal function (nephrotoxic)
- Monitor for signs of infection
- CBC for myelosuppression
- Trough levels — narrow therapeutic range
- Trough levels — narrow therapeutic range
- CBC — neutropenia/anemia
- ★Gingival hyperplasia + hirsutism
- Hypertension
- ★New-onset diabetes + neurotoxic tremor
- Alopecia
- Hypertension
- Diarrhea, GI upset
- Myelosuppression
- ↑ Infection & malignancy risk
- ↑ Infection & malignancy risk
- ↑ Infection & malignancy risk
- ★Teratogen — pregnancy loss/malformation
- Avoid grapefruit (↑ levels)
- Avoid grapefruit (↑ levels)
- Pregnancy: strict contraception
- No live vaccines
- No live vaccines
- No live vaccines
Cyclosporine
- Calcineurin inhibitor
- Binds cyclophilin, ↓ IL-2
Tacrolimus
- Calcineurin inhibitor
- Binds FKBP; more potent
Cyclosporine
- Transplant rejection prophylaxis
Tacrolimus
- Transplant rejection prophylaxis
Cyclosporine
- PO/IV
Tacrolimus
- PO/IV
Cyclosporine
- Monitor for signs of infection
- Renal function (nephrotoxic)
Tacrolimus
- Monitor for signs of infection
- Renal function (nephrotoxic)
Cyclosporine
- Trough levels — narrow therapeutic range
Tacrolimus
- Trough levels — narrow therapeutic range
Cyclosporine
- ★Gingival hyperplasia + hirsutism
- Hypertension
Tacrolimus
- ★New-onset diabetes + neurotoxic tremor
- Alopecia
- Hypertension
Cyclosporine
- ↑ Infection & malignancy risk
Tacrolimus
- ↑ Infection & malignancy risk
Cyclosporine
- Avoid grapefruit (↑ levels)
Tacrolimus
- Avoid grapefruit (↑ levels)
Cyclosporine
- No live vaccines
Tacrolimus
- No live vaccines
★ marks the fact that sets a column apart.
Tap the column each item belongs to — jump in and play, or just watch it run.
Play full screen for XPClinical Pearl
Cyclosporine grows gums and hair; tacrolimus grows glucose; mycophenolate drops your marrow and your GI.
Component Topics
Ready to master this comparison?
Get a personalized study plan built around this topic — free to try, no card needed.
Go further
- TopicChemotherapyA single splash of cyclophosphamide on ungloved skin can cause mutagenic exposure — and the nurse, not the patient, becomes the victim. Safe handling isn't optional; it's…
- Guide94 Million Alaris IV Sets Recalled. The Trouble Zone: Under 1 mL/hFDA's October update says some BD Alaris sets perform worse than BD disclosed, mostly at low rates and small boluses. What's new and what to do.
- GuideExplain It Simply: The Three-Sentence Fix for a Missed Nursing QuestionWhen you missed a question because of one fact, you need the fact, why it decides the question, and the trap. How NurseSavvy’s Explain simply mode does it in 50 words, with a real example.
- FinderAI Prompt Library for Nursing StudentsEvery copy-ready AI prompt from our nursing study guides in one place: concept explanations, rationale autopsies, pharmacology, ABGs, and care plans.