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Drug interactions

Amlodipine-hydrochlorothiazide-valsartan + Tacrolimus

Severity: Moderate

Amlodipine-hydrochlorothiazide-valsartan and Tacrolimus: moderate 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

Amlodipine may modestly raise tacrolimus blood concentrations, possibly through CYP3A4 competition. Tacrolimus has a narrow therapeutic index, so increased levels can lead to nephrotoxicity and neurotoxicity. Tacrolimus-related hyperkalemia and nephrotoxicity may also be worsened by valsartan.

What this interaction means in plain words

Amlodipine-hydrochlorothiazide-valsartan and Tacrolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Amlodipine-hydrochlorothiazide-valsartan belongs to Cardiovascular; Tacrolimus belongs to Miscellaneous.

Evidence level: Low

Why it happens

Possible inhibition of CYP3A4-mediated tacrolimus metabolism by amlodipine; additive hyperkalemia with valsartan.

What to do

Monitor tacrolimus trough levels, renal function and potassium after starting or changing amlodipine, and adjust the tacrolimus dose accordingly.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Amlodipine-hydrochlorothiazide-valsartan with Tacrolimus?

MediHelp rates the interaction as moderate. Amlodipine-hydrochlorothiazide-valsartan and Tacrolimus can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amlodipine may modestly raise tacrolimus blood concentrations, possibly through CYP3A4 competition. Tacrolimus has a narrow therapeutic index, so increased levels can lead to nephrotoxicity and neurotoxicity. Tacrolimus-related hyperkalemia and nephrotoxicity may also be worsened by valsartan.

How serious is the interaction between Amlodipine-hydrochlorothiazide-valsartan and Tacrolimus?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor tacrolimus trough levels, renal function and potassium after starting or changing amlodipine, and adjust the tacrolimus dose accordingly.

What other medicines interact with Amlodipine-hydrochlorothiazide-valsartan?

MediHelp also lists interactions of Amlodipine-hydrochlorothiazide-valsartan with, for example, Aliskiren, Dofetilide, Sparsentan. The full list is on the Amlodipine-hydrochlorothiazide-valsartan page.

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