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Drug Interactions With Tacrolimus

Alcohol, echinacea, and even grapefruit juice may cause potentially dangerous reactions when combined with tacrolimus. Drug interactions such as these may increase your risk for side effects or decrease the effectiveness of the medicines. Make sure to tell your healthcare provider about all medications and supplements you are taking before starting treatment with tacrolimus to help minimize your risk for problems.

An Overview of Tacrolimus Interactions

Tacrolimus (Prograf®, Protopic®) may react with a number of other medications. Some of the products that may lead to drug interactions with tacrolimus include:


  • CYP 3A4 inhibitor medications, such as:
  • Medications that cause a certain change in the heart rhythm known as QT prolongation (see QT-Prolonging Medications for a list of such medications)
  • Other immunosuppressants, such as:
    • Corticosteroids, such as:
      • Betamethasone (Celestone®)
      • Cortisone
      • Dexamethasone (Decadron®)
      • Fludrocortisone (Florinef®)
      • Hydrocortisone (Cortef®)
      • Methylprednisolone (Depo-Medrol®, Medrol®)
      • Prednisolone (Pediapred®)
      • Prednisone
      • Triamcinolone (Kenalog®)
  • P-glycoprotein inducers, such as:
  • P-glycoprotein inhibitors, such as:
  • Proton pump inhibitors (PPIs), such as:

Tacrolimus Drug Information

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