Selected Immunosuppressants/Posaconazole; Voriconazole 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:

Antifungal medicines may may slow down how quickly your body processes cyclosporine, tacrolimus, and temsirolimus.

What might happen:

Your blood levels of cyclosporine, tacrolimus, or temsirolimus may increase and cause toxic effects that may harm your kidneys.

What you should do about this interaction:

Make sure that your doctor knows all of the medicines that you are taking.Tell your doctor if you have any kidney problems. If you experience any shortness of breath, unusual swelling, changes in the color or amount of your urine, or changes in how often you urinate, contact your doctor.The amount of cyclosporine, tacrolimus, or temsirolimus in your blood may need to be checked more often and the dosage adjusted when you first start or stop taking the antifungal medicine.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.Noxafil (posaconazole) US prescribing information. Merck & Co. Inc September, 2016.
  • 2.Noxafil (posaconazole) UK summary of product characteristics. Schering-Plough Ltd. February 2, 2006.
  • 3.Torisel (temsirolimus) US prescribing information. Wyeth Pharmaceuticals, Inc. May 22, 2017.
  • 4.Prograf (tacrolimus) US prescribing information. Fujisawa Healthcare, Inc. May 19, 2015.
  • 5.Sansone-Parsons A, Krishna G, Martinho M, Kantesaria B, Gelone S, Mant TG. Effect of oral posaconazole on the pharmacokinetics of cyclosporine and tacrolimus. Pharmacotherapy 2007 Jun;27(6):825-34.
  • 6.Vfend (voriconazole) US prescribing information. Pfizer Inc. July, 2017. 7.Romero AJ, Pogamp PL, Nilsson LG, Wood N. Effect of voriconazole on the pharmacokinetics of cyclosporine in renal transplant patients. Clin Pharmacol Ther 2002 Apr;71(4):226-34.
  • 7.Sadaba B, Campanero MA, Quetglas EG, Azanza JR. Clinical relevance of sirolimus drug interactions in transplant patients. Transplant Proc 2004 Dec;36(10):3226-8.
  • 8.Capone D, Tarantino G, Gentile A, Sabbatini M, Polichetti G, Santangelo M, Nappi R, Ciotola A, D'Alessandro V, Renda A, Basile V, Federico S. Effects of voriconazole on tacrolimus metabolism in a kidney transplant recipient. J Clin Pharm Ther 2010 Feb;35(1):121-4.
  • 9.Kramer MR, Amital A, Fuks L, Shitrit D. Voriconazole and itraconazole in lung transplant recipients receiving tacrolimus (FK 506): efficacy and drug interaction. Clin Transplant 2010 Dec 16.
  • 10.Mori T, Aisa Y, Kato J, Nakamura Y, Ikeda Y, Okamoto S. Drug interaction between voriconazole and calcineurin inhibitors in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 2009 Sep;44(6):371-4.

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, expect 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.