Drug interactions
Amikacin + Tacrolimus
Severity: Major
Amikacin and Tacrolimus: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs are nephrotoxic, and combined use raises the risk of acute kidney injury. Aminoglycoside ototoxicity and tacrolimus neurotoxicity may also add together.
What this interaction means in plain words
Amikacin and Tacrolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amikacin belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity, with tacrolimus causing afferent arteriolar vasoconstriction and amikacin causing proximal tubular injury.
What to do
Avoid if alternatives exist. If required, monitor serum creatinine, amikacin levels and tacrolimus trough concentrations closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Amikacin
- Amikacin + Cidofovir Contraindicated
- Adefovir + Amikacin Major
- Amikacin + Amphotericin b Major
- Amikacin + Amphotericin b deoxycholate Major
- Amikacin + Atracurium Major
- Amikacin + Bacitracin Major
Other interactions of Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Amikacin with Tacrolimus?
MediHelp rates the interaction as major. Amikacin and Tacrolimus can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs are nephrotoxic, and combined use raises the risk of acute kidney injury. Aminoglycoside ototoxicity and tacrolimus neurotoxicity may also add together.
How serious is the interaction between Amikacin and Tacrolimus?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if alternatives exist. If required, monitor serum creatinine, amikacin levels and tacrolimus trough concentrations closely.
What other medicines interact with Amikacin?
MediHelp also lists interactions of Amikacin with, for example, Cidofovir, Adefovir, Amphotericin b. The full list is on the Amikacin page.
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