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Drug Interactions With Tacrolimus

Live Vaccinations
People who are taking oral tacrolimus should not receive live vaccines. In addition, other vaccines may be less effective during tacrolimus treatment. Talk to your healthcare provider before receiving any vaccination or immunization when taking oral tacrolimus.
QT-Prolonging Medications
Tacrolimus can cause QT prolongation (a certain change in the heart rhythm). Combining tacrolimus with other medications that also cause this problem can increase the risk of a life-threatening arrhythmia. If such a combination is unavoidable, very careful monitoring of the heart rhythm using an electrocardiogram, blood electrolytes (since electrolyte imbalances increase the risk of an arrhythmia), and tacrolimus blood levels is recommended. This interaction is not a concern with tacrolimus ointment.
Immunosuppressant Medications
It is generally recommended that people taking other immunosuppressant medications not use tacrolimus ointment, due to the increased risk for infection, lymphoma (cancer of the lymph nodes), and skin cancer. The risk for these side effects is higher with larger doses and long-term use. Oral and injectable tacrolimus are often used with other immunosuppressants for the prevention of transplant rejection. Talk to your healthcare provider before using tacrolimus with another immunosuppressant.
P-glycoprotein (Pgp) Inducers
P-glycoprotein is a natural protein that helps remove substances, such as medications, from the tissues in the body so they can be excreted through the urine or feces. Pgp helps remove tacrolimus from the body, and medications known as Pgp inducers increase the activity of Pgp.
When tacrolimus is taken with a Pgp inducer, it may be removed from the body too quickly, potentially making it less effective. Your healthcare provider may choose to monitor your tacrolimus blood levels more closely if you take it with a Pgp inducer, and adjust your dose as needed. This interaction is not a concern with tacrolimus ointment.

Tacrolimus Drug Information

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