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Prilosec oral

Tacrolimus/Selected Proton Pump Inhibitors

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:

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:

Your ulcer medication may slow down how quickly your body process tacrolimus.

What might happen:

The amount of tacrolimus in your blood may increase and cause more side effects than expected.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. 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 may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.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.
2.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.
3.Moreau C, Debray D, Loriot MA, Taburet AM, Furlan V. Interaction between tacrolimus and omeprazole in a pediatric liver transplant recipient. Transplantation 2006 Feb 15;81(3):487-8.
4.Takahashi K, Yano I, Fukuhara Y, Katsura T, Takahashi T, Ito N, Yamamoto S, Ogawa O, Inui K. Distinct effects of omeprazole and rabeprazole on the tacrolimus blood concentration in a kidney transplant recipient. Drug Metab Pharmacokinet 2007 Dec;22(6):441-4.
5.Lemahieu WP, Maes BD, Verbeke K, Vanrenterghem Y. Impact of gastric acid suppressants on cytochrome P450 3A4 and P-glycoprotein: consequences for FK506 assimilation. Kidney Int 2005 Mar;67(3):1152-60.
6.Pascual J, Marcen R, Orea OE, Navarro M, Alarcon MC, Ocana J, Villafruela JJ, Burgos FJ, Ortuno J. Interaction between omeprazole and tacrolimus in renal allograft recipients: a clinical-analytical study. Transplant Proc 2005 Nov;37(9):3752-3.
7.Katsakiori PF, Papapetrou EP, Goumenos DS, Nikiforidis GC, Flordellis CS. Investigation of clinical interaction between omeprazole and tacrolimus in CYP3A5 non-expressors, renal transplant recipients. Ther Clin Risk Manag 2010;6:265-9.
8.Hosohata K, Masuda S, Katsura T, Takada Y, Kaido T, Ogura Y, Oike F, Egawa H, Uemoto S, Inui K. Impact of intestinal CYP2C19 genotypes on the interaction between tacrolimus and omeprazole, but not lansoprazole, in adult living-donor liver transplant patients. Drug Metab Dispos 2009 Apr; 37(4):821-6.
9.Itagaki F, Homma M, Yuzawa K, Fukao K, Kohda Y. Drug interaction of tacrolimus and proton pump inhibitors in renal transplant recipients with CYP2C19 gene mutation. Transplant Proc 2002 Nov;34(7):2777-8.
10.Takahashi K, Motohashi H, Yonezawa A, Okuda M, Ito N, Yamamoto S, Ogawa O, Inui K. Lansoprazole-tacrolimus interaction in Japanese transplant recipient with CYP2C19 polymorphism. Ann Pharmacother 2004 May; 38(5):791-4.
11.Homma M, Itagaki F, Yuzawa K, Fukao K, Kohda Y. Effects of lansoprazole and rabeprazole on tacrolimus blood concentration: case of a renal transplant recipient with CYP2C19 gene mutation. Transplantation 2002 Jan 27;73(2):303-4.
12.Hosohata K, Masuda S, Ogura Y, Oike F, Takada Y, Katsura T, Uemoto S, Inui K. Interaction between tacrolimus and lansoprazole, but not rabeprazole in living-donor liver transplant patients with defects of CYP2C19 and CYP3A5. Drug Metab Pharmacokinet 2008;23(2):134-8.
13.Miura M, Inoue K, Kagaya H, Satoh S, Tada H, Sagae Y, Habuchi T, Suzuki T. Influence of rabeprazole and lansoprazole on the pharmacokinetics of tacrolimus in relation to CYP2C19, CYP3A5 and MDR1 polymorphisms in renal transplant recipients. Biopharm Drug Dispos 2007 May;28(4):167-75.
14.Itagaki F, Homma M, Yuzawa K, Nishimura M, Naito S, Ueda N, Ohkohchi N, Kohda Y. Effect of lansoprazole and rabeprazole on tacrolimus pharmacokinetics in healthy volunteers with CYP2C19 mutations. J Pharm Pharmacol 2004 Aug;56(8):1055-9.
15.Hosohata K, Masuda S, Yonezawa A, Sugimoto M, Takada Y, Kaido T, Ogura Y, Oike F, Uemoto S, Inui K. Absence of influence of concomitant administration of rabeprazole on the pharmacokinetics of tacrolimus in adult living-donor liver transplant patients: a case-control study. Drug Metab Pharmacokinet 2009;24(5):458-63.
16.Lorf T, Ramadori G, Ringe B, Schworer H. The effect of pantoprazole on tacrolimus and cyclosporin A blood concentration in transplant recipients. Eur J Clin Pharmacol 2000 Aug;56(5):439-40.

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