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Drug Interactions With Tacrolimus

P-glycoprotein (Pgp) Inhibitors
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 certain medications known as Pgp inhibitors decrease the activity of Pgp.
 
When tacrolimus is taken with a Pgp inhibitor, it may be removed from the body more slowly, potentially increasing tacrolimus blood levels and the risk for side effects. Your healthcare provider may choose to monitor you more closely if you take these drugs together, and lower your dose if needed. This interaction is not likely to be a concern with tacrolimus ointment.
 
Pimecrolimus
It is recommended that people taking immunosuppressants, including tacrolimus, not use pimecrolimus because of the increased risk for infections, lymphoma (cancer of the lymph nodes), and skin cancer.
 
Potassium-Sparing Diuretics
Combining potassium-sparing diuretics with tacrolimus may increase the risk for high blood potassium levels (hyperkalemia). In general, these medicines should not be taken together. This interaction is not a concern with tacrolimus ointment.
 
Proton Pump Inhibitors (PPIs)
PPIs may increase oral tacrolimus blood levels, potentially increasing your risk for side effects. Talk to your healthcare provider before taking a PPI during tacrolimus treatment.
 
Silodosin
Tacrolimus may increase the amount of silodosin in your blood, possibly increasing your risk for side effects. It is generally recommended that these medicines not be used together. This interaction is not a concern with tacrolimus ointment.
 
Topotecan
Tacrolimus may increase the amount of topotecan in your blood, potentially increasing your risk for side effects. It is generally recommended that these drugs not be taken together. This interaction is expected to be more significant when topotecan is taken by mouth, compared with the intravenous (IV) form. Tacrolimus ointment is not expected to cause problems with either form of topotecan.
 

Tacrolimus Drug Information

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