Tacrolimus/Selected Weak CYP3A4 Inhibitors that Prolong QT 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:

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 other drug may slow down how quickly your body processes tacrolimus.Also, both drugs can affect your heart's rhythm.

What might happen:

Your blood levels of tacrolimus may increase and cause toxic effects. Taking your other medicine with tacrolimus can affect your heart rhythm and may increase your risk of an irregular heartbeat, which may be life-threatening.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these two medicines together. Your doctor may need to check the amount of tacrolimus in your blood and adjust the dose until you have been stabilized on the combination.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. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. December, 2020.
  • 2.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.
  • 3.Kisters K, Cziborra M, Funke C, Brylak S, Hausberg M. Amiodarone-tacrolimus interaction in kidney transplantation. Clin Nephrol 2008 Dec;70(6):563.
  • 4.Burger CI, Clase CM, Gangji AS. Case report: drug interaction between tacrolimus and amiodarone with QT prolongation. Transplantation 2010 May 15;89(9):1166-7.
  • 5.Mori T, Aisa Y, Nakazato T, Yamazaki R, Ikeda Y, Okamoto S. Tacrolimus-azithromycin interaction in a recipient of allogeneic bone marrow transplantation. Transpl Int 2005 Jun;18(6):757-8.
  • 6.Pierce Dwayne A, Reeves-Daniel Amber M. Ranolazine-tacrolimus interaction. Ann Pharmacother 2010 Nov;44(11):1844-1849.
  • 7.Seck Sidy, Bellantoni Marianna, Zoccali Carmine, Enia Giuseppe. Ranolazine can markedly increase tacrolimus blood levels. NDT Plus 2011 Feb; 4(1):44-45.
  • 8.Patni Hitesh, Gitman Michael, Hazzan Azzour, Jhaveri Kenar D. Ranolazine, tacrolimus, and diltiazem might be a hazardous combination in a transplant patient. Ren Fail 2012 Jan;34(2):251-253.
  • 9.This information is based on or an extract from the UW Metabolism and Transport Drug Interaction Database (DIDB) Platform, Copyright University of Washington 1999-2019..

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

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.