Tacrolimus/Nicardipine 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 tacrolimus correctly.
What might happen:
Your blood levels of tacrolimus may increase and cause toxic effects, including kidney damage and an irregular heartbeat, which may be life-threatening.
What you should do about this interaction:
Contact your healthcare professional if you experience a decrease in the amount of urine you make, or any chest discomfort, irregular heartbeat, dizziness, fainting, shaking, leg cramping, swelling, or any unusual stomach upset, headache, or skin irritation.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.Cardene (nicardipine) US prescribing information. EKR Therapeutics, Inc. August, 2016.
- 3.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.
- 4.Lampen A, Christians U, Guengerich FP, Watkins PB, Kolars JC, Bader A, Gonschior AK, Dralle H, Hackbarth I, Sewing KF. Metabolism of the immunosuppressant tacrolimus in the small intestine: cytochrome P450, drug interactions, and interindividual variability. Drug Metab Dispos 1995 Dec; 23(12):1315-24.
- 5.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.
- 6.Hooper DK, Fukuda T, Gardiner R, Logan B, Roy-Chaudhury A, Kirby CL, Vinks AA, Goebel J. Risk of tacrolimus toxicity in CYP3A5 nonexpressors treated with intravenous nicardipine after kidney transplantation. Transplantation 2012 Apr 27;93(8):806-12.
- 7.Hooper DK, Carle AC, Schuchter J, Goebel J. Interaction between tacrolimus and intravenous nicardipine in the treatment of post-kidney transplant hypertension at pediatric hospitals. Pediatr Transplant 2011 Feb; 15(1):88-95.
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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.