Tacrolimus/Cyclosporine 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:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Both of these medicines can harm your kidneys.

What might happen:

Taking these medicines together increases your risk of developing problems with your kidneys.

What you should do about this interaction:

If you are taking these medicines together, let your healthcare professional (e.g. doctor or pharmacist) know. If you doctor decides that this is the best therapy for you, your doctor will closely monitor the amounts of tacrolimus and cyclosporine in your blood, as well as your kidney function. Be sure to keep all laboratory appointments.If your doctor is switching you from tacrolimus to cyclosporine or from cyclosporine to tacrolimus, your doctor may want you to wait at least 24 hours after your last dose of the first medicine before beginning the second medicine. If the reason you are switching medicines is because you are already having problems with your kidneys, your doctor may want you to wait longer between the medicines.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.

  • 1.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. June, 2019.
  • 2.Neoral (cyclosporine) US prescribing information. Novartis Pharmaceuticals Corporation March, 2015.
  • 3.Sandimmune (cyclosporine) US prescribing information. Novartis Pharmaceuticals Corporation March, 2015.
  • 4.Sinha A, Sharma A, Mehta A, Gupta R, Gulati A, Hari P, Dinda AK, Bagga A. Calcineurin inhibitor induced nephrotoxicity in steroid resistant nephrotic syndrome. Indian J Nephrol 2013 Jan;23(1):41-6.
  • 5.Cicinnati VR, Yu Z, Klein CG, Sotiropoulos GC, Saner F, Malago M, Frilling A, Gerken G, Broelsch CE, Beckebaum S. Clinical trial: switch to combined mycophenolate mofetil and minimal dose calcineurin inhibitor in stable liver transplant patients--assessment of renal and allograft function, cardiovascular risk factors and immune monitoring. Aliment Pharmacol Ther 2007 Nov 1;26(9):1195-208.

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.