Drug interactions
Canagliflozin + Tacrolimus
Severity: Moderate
Canagliflozin 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
Tacrolimus commonly causes hyperkalemia and nephrotoxicity. Canagliflozin may add to risk through volume depletion and changes in renal function, and the label notes a potassium increase with canagliflozin in some patients.
What this interaction means in plain words
Canagliflozin 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.
Canagliflozin belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Tacrolimus reduces renal potassium excretion; canagliflozin may add via volume depletion and hemodynamic renal effects.
What to do
Monitor serum potassium, creatinine and volume status, especially after starting canagliflozin.
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?
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Other interactions of Canagliflozin
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 Canagliflozin with Tacrolimus?
MediHelp rates the interaction as moderate. Canagliflozin 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. Tacrolimus commonly causes hyperkalemia and nephrotoxicity. Canagliflozin may add to risk through volume depletion and changes in renal function, and the label notes a potassium increase with canagliflozin in some patients.
How serious is the interaction between Canagliflozin 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 serum potassium, creatinine and volume status, especially after starting canagliflozin.
What other medicines interact with Canagliflozin?
MediHelp also lists interactions of Canagliflozin with, for example, Aliskiren, Amiloride, Amlodipine-benazepril. The full list is on the Canagliflozin page.
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