Drug interactions
Canagliflozin-metformin + Tacrolimus
Severity: Moderate
Canagliflozin-metformin 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 can cause hyperglycemia and post-transplant diabetes, reducing the effect of metformin and canagliflozin. It also commonly causes hyperkalemia and nephrotoxicity, which may add to potassium effects of canagliflozin and increase the risk of metformin accumulation.
What this interaction means in plain words
Canagliflozin-metformin 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-metformin belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Tacrolimus impairs insulin secretion and reduces renal potassium excretion and renal function, with additive potassium and volume effects from canagliflozin.
What to do
Monitor glucose, serum potassium and renal function regularly. Adjust antidiabetic therapy and reconsider metformin if eGFR declines significantly.
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-metformin
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-metformin with Tacrolimus?
MediHelp rates the interaction as moderate. Canagliflozin-metformin 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 can cause hyperglycemia and post-transplant diabetes, reducing the effect of metformin and canagliflozin. It also commonly causes hyperkalemia and nephrotoxicity, which may add to potassium effects of canagliflozin and increase the risk of metformin accumulation.
How serious is the interaction between Canagliflozin-metformin 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 glucose, serum potassium and renal function regularly. Adjust antidiabetic therapy and reconsider metformin if eGFR declines significantly.
What other medicines interact with Canagliflozin-metformin?
MediHelp also lists interactions of Canagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Canagliflozin-metformin page.
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