Drug interactions
Berotralstat + Tacrolimus
Severity: Major
Berotralstat 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
Berotralstat inhibits P-gp and CYP3A4 and may raise tacrolimus concentrations. Because tacrolimus has a narrow therapeutic index, toxicity such as nephrotoxicity may result.
What this interaction means in plain words
Berotralstat 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.
Berotralstat belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
Inhibition of P-glycoprotein and CYP3A4 reduces tacrolimus efflux and metabolism.
What to do
Monitor tacrolimus trough concentrations and renal function when starting or stopping berotralstat, and reduce the tacrolimus dose as needed.
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 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
Other interactions of Berotralstat
Frequently asked questions
Can I take Berotralstat with Tacrolimus?
MediHelp rates the interaction as major. Berotralstat 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. Berotralstat inhibits P-gp and CYP3A4 and may raise tacrolimus concentrations. Because tacrolimus has a narrow therapeutic index, toxicity such as nephrotoxicity may result.
How serious is the interaction between Berotralstat 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 concentrations and renal function when starting or stopping berotralstat, and reduce the tacrolimus dose as needed.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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