Medication Review: What Are the Clinically Meaningful Differences Between Voclosporin and Other Calcineurin Inhibitors?

In this video, Jessica Farrell, PharmD—clinical pharmacist at Albany Medical Center and professor at Albany College of Pharmacy and Health Sciences—explains the clinically meaningful differences between voclosporin and other calcineurin inhibitors, such as cyclosporine and tacrolimus, in the treatment of lupus nephritis. She highlights how voclosporin’s unique molecular structure leads to increased potency, faster elimination, and more stable pharmacokinetics. Unlike other calcineurin inhibitors, voclosporin offers more consistent oral bioavailability and does not require routine therapeutic drug monitoring. Dr. Farrell also reviews important distinctions in drug-drug interactions, particularly with mycophenolate, and notes that voclosporin may present a lower risk of hyperkalemia and metabolic side effects, such as lipid and glucose abnormalities. While voclosporin is not currently recommended during pregnancy, it remains a promising treatment option for many patients with lupus nephritis. For more expert-led rheumatology education, visit RhAPP.org or explore the RhAPP ACE App.