Drug interactions
Amiodarone + Tacrolimus
Severity: Major
Amiodarone 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 can prolong the QT interval, raising arrhythmia risk. Amiodarone may also inhibit tacrolimus metabolism and increase its levels, raising the risk of nephrotoxicity.
What this interaction means in plain words
Amiodarone 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.
Amiodarone belongs to Cardiovascular; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QTc prolongation, with possible amiodarone inhibition of CYP3A4 and P-gp increasing tacrolimus exposure.
What to do
Monitor tacrolimus trough levels and adjust the dose, and monitor ECG and electrolytes. Check renal function regularly.
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 Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
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 Amiodarone with Tacrolimus?
MediHelp rates the interaction as major. Amiodarone 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 can prolong the QT interval, raising arrhythmia risk. Amiodarone may also inhibit tacrolimus metabolism and increase its levels, raising the risk of nephrotoxicity.
How serious is the interaction between Amiodarone 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: Monitor tacrolimus trough levels and adjust the dose, and monitor ECG and electrolytes. Check renal function regularly.
What other medicines interact with Amiodarone?
MediHelp also lists interactions of Amiodarone with, for example, Amisulpride, Arsenic trioxide, Dofetilide. The full list is on the Amiodarone page.
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