Tacrolimus/Selected Calcium Channel Blockers
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.
Moderate. These medicines may cause some risk when taken together. 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.
What you should do about this interaction:
Contact your doctor if you experience a decrease in the amount of urine you make, if you develop any new side effects from your medicine, or if have any dizziness or fainting episodes.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.Jones TE, Morris RG. Pharmacokinetic interaction between tacrolimus and diltiazem: dose-response relationship in kidney and liver transplant recipients. Clin Pharmacokinet 2002;41(5):381-8.
2.Hebert MF, Lam AY. Diltiazem increases tacrolimus concentrations. Ann Pharmacother 1999 Jun;33(6):680-2.
3.Hardy G, Stanke-Labesque F, Contamin C, Serre-Debeauvais F, Bayle F, Zaoui P, Bessard G. Protease inhibitors and diltiazem increase tacrolimus blood concentration in a patient with renal transplantation: a case report. Eur J Clin Pharmacol 2004 Oct;60(8):603-5.
4.Kothari J, Nash M, Zaltzman J, Ramesh Prasad GV. Diltiazem use in tacrolimus-treated renal transplant recipients. J Clin Pharm Ther 2004 Oct;29(5):425-30.
5.Butani L, Berg G, Makker SP. Effect of felodipine on tacrolimus pharmacokinetics in a renal transplant recipient. Transplantation 2002 Jan 15;73(1):159-60.
6.Seifeldin R, Marcos-Alvarez A, Lewis WD, Gordon FD, Jenkins RL. Effect of nifedipine on renal function in liver transplant recipients receiving tacrolimus. Clin Ther 1996 May-Jun;18(3):491-6.
7.Seifeldin RA, Marcos-Alvarez A, Gordon FD, Lewis WD, Jenkins RL. Nifedipine interaction with tacrolimus in liver transplant recipients. Ann Pharmacother 1997 May;31(5):571-5.
8.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. September, 2013.
9.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.
10.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.