Tacrolimus/Selected Macrolides Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
When these two medicines are taken together, your body may not be able to process your tacrolimus properly.
What might happen:
Your blood levels of your medicines may increase and cause toxic side effects.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to check the amount of medicine in your blood and may want to change the amount of medicine you take. Let your doctor know if you experience a decrease in the amount of urine you make or if you experience bloody urine, frequent urges to urinate, headache, dizziness or blurred vision.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, it may be necessary to adjust the dose of tacrolimus or change you to a different medicine. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Prograf (tacrolimus) US prescribing information. Astellas Pharma US, Inc. August, 2023.
- 2.Padhi ID, Long P, Basha M, Anandan JV. Interaction between tacrolimus and erythromycin. Ther Drug Monit 1997 Feb;19(1):120-2.
- 3.Jensen C, Jordan M, Shapiro R, Scantlebury V, Hakala T, Fung J, Starzl T, Venkataramanan R. Interaction between tacrolimus and erythromycin. Lancet 1994 Sep 17;344(8925):825.
- 4.Shaeffer MS, Collier D, Sorrell MF. Interaction between FK506 and erythromycin. Ann Pharmacother 1994 Feb;28(2):280-1.
- 5.Furlan V, Perello L, Jacquemin E, Debray D, Taburet AM. Interactions between FK506 and rifampicin or erythromycin in pediatric liver recipients. Transplantation 1995 Apr 27;59(8):1217-8.
- 6.Wolter K, Wagner K, Philipp T, Fritschka E. Interaction between FK 506 and clarithromycin in a renal transplant patient. Eur J Clin Pharmacol 1994; 47(2):207-8.
- 7.Katari SR, Magnone M, Shapiro R, Jordan M, Scantlebury V, Vivas C, Gritsch A, McCauley J, Starzl T, Demetris AJ, Randhawa PS. Clinical features of acute reversible tacrolimus (FK 506) nephrotoxicity in kidney transplant recipients. Clin Transplant 1997 Jun;11(3):237-42.
- 8.Christians U, Schmidt G, Bader A, Lampen A, Schottmann R, Linck A, Sewing KF. Identification of drugs inhibiting the in vitro metabolism of tacrolimus by human liver microsomes. Br J Clin Pharmacol 1996 Mar; 41(3):187-90.
- 9.Sparkes T, Lemonovich TL. Interactions between anti-infective agents and immunosuppressants-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019 Feb 28; e13510.
- 10.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.