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Drug interactions

Blinatumomab + Tacrolimus

Severity: Moderate

Blinatumomab 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

Cytokine release at the start of blinatumomab treatment can temporarily suppress CYP450 enzymes, which may raise tacrolimus concentrations. Elevated tacrolimus levels increase the risk of nephrotoxicity and neurotoxicity.

What this interaction means in plain words

Blinatumomab 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.

Blinatumomab belongs to Oncology; Tacrolimus belongs to Miscellaneous.

Evidence level: Moderate

Why it happens

Transient cytokine-mediated suppression of CYP3A4 reduces tacrolimus metabolism.

What to do

Monitor tacrolimus trough levels and renal function closely during the first days of each blinatumomab cycle. Reduce the tacrolimus dose as needed.

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 Blinatumomab with Tacrolimus?

MediHelp rates the interaction as moderate. Blinatumomab 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. Cytokine release at the start of blinatumomab treatment can temporarily suppress CYP450 enzymes, which may raise tacrolimus concentrations. Elevated tacrolimus levels increase the risk of nephrotoxicity and neurotoxicity.

How serious is the interaction between Blinatumomab 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 and renal function closely during the first days of each blinatumomab cycle. 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.

Full monographs, dosing and an interaction checker in the MediHelp app

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