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Drug Interactions With Tacrolimus

CYP 3A4 Inhibitor Medications
The liver breaks down tacrolimus using enzymes known as CYP 3A4 enzymes. Medications known as CYP 3A4 inhibitors can decrease the activity of these enzymes. Thus, combining tacrolimus with one of these drugs may increase the level of tacrolimus in your body, potentially increasing your risk for side effects. Your healthcare provider may choose to monitor you more closely if you take these medicines together, and adjust your dose as needed. Although this interaction is less likely to occur with tacrolimus ointment, the combination may still require careful monitoring.
 
Dabigatran
Combining tacrolimus with dabigatran could increase your dabigatran blood levels, as well as your risk for bleeding. Talk to your healthcare provider before combining these medicines. He or she may want to monitor you more closely, and possibly reduce your dabigatran dosage. This interaction is not likely to occur with tacrolimus ointment.
 
Echinacea
Echinacea could decrease the effectiveness of tacrolimus. Do not take echinacea while using tacrolimus without first talking with your healthcare provider.
 
Grapefruit Juice
You should not drink grapefruit juice or eat grapefruit while taking tacrolimus. Grapefruit juice may increase the amount of tacrolimus in your body, potentially increasing your risk for side effects. This interaction is not likely to occur with tacrolimus ointment.
 
Leflunomide
Combining leflunomide with tacrolimus may increase your risk for certain blood cell problems, such as abnormally low red blood cells, white blood cells, and platelets. Talk to your healthcare provider before taking these medicines together. This interaction is not likely a concern when using tacrolimus ointment.

Tacrolimus Drug Information

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