0 known interactions • 0 major • 0 moderate • 0 minor
Always disclose all medications to your healthcare providers — prescription medicines, OTC medications, vitamins, and herbal supplements. This list may not include every possible interaction. Use our free drug interaction checker to screen your complete medication list.
Potentially life-threatening or causing permanent damage. Avoid combination.
May worsen condition or require dose adjustment. Monitor closely.
Usually limited clinical effect. Manage with routine monitoring.
7 DRUG INTERACTIONS Risk of rejection with strong CYP3A inducers and risk of serious adverse reactions with strong CYP3A inhibitors: Adjust dose and monitor tacrolimus concentrations. ( 2.4 , 5.10 , 7.2 ) Therapeutic drug monitoring and dose reduction for tacrolimus extended-release capsules should be considered when tacrolimus extended-release capsules is co-administered with cannabidiol. ( 2.4 , 5.15 , 7.3 ) See Full Prescribing Information for clinically significant drug interactions. ( 7.1 , 7.2 , 7.3 ) 7.1 Mycophenolic Acid When tacrolimus extended-release capsules is prescribed with a given dose of a mycophenolic acid (MPA) product, exposure to MPA is higher with tacrolimus extended-release capsules co-administration than with cyclosporine co-administration with MPA, because cyclosporine interrupts the enterohepatic recirculation of MPA while tacrolimus does not. Monitor for MPA-associated adverse reactions and reduce the dose of concomitantly administered mycophenolic acid products as needed. 7.2 Effects of Other Drugs on Tacrolimus Extended-Release Capsules Table 5 displays the effects of other drugs on tacrolimus extended-release capsules. Table 5: Effects of Other Drugs/Substances on Tacrolimus Extended-Release Capsules Tacrolimus extended-release capsules dosage adjustment recommendation based on observed effect of co-administered drug on tacrolimus exposures [see Clinical Pharmacology ( 12.3)] , literature reports of altered tacrolimus exposures, or the other drug’s known CYP3A inhibitor/inducer status. Drug/Substance Class or Name Drug Interaction Effect Recommendations Grapefruit or grapefruit juice High dose or double strength grapefruit juice is a strong CYP3A inhibitor; low dose or single strength grapefruit juice is a moderate CYP3A inhibitor. May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see Warnings and Precautions ( 5.7 , 5.10 , 5.11 )] . Avoid
Source: FDA-approved prescribing information. Severity ratings are not assigned in this excerpt — ask your pharmacist to help interpret specific interactions.
Always ask your pharmacist about potential interactions with food, alcohol, and supplements specific to Tacrolimus. Some medicines have significant interactions with grapefruit juice, high-fat meals, dairy products, or vitamin K-rich foods.