Drug interactions
Canakinumab + Tacrolimus
Severity: Major
Canakinumab 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
Canakinumab blocks interleukin-1 beta and is associated with an increased rate of serious infection. Adding tacrolimus, a calcineurin inhibitor, further suppresses immunity and may raise the risk of serious or opportunistic infection.
What this interaction means in plain words
Canakinumab 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.
Canakinumab belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression from IL-1 beta blockade plus calcineurin inhibition.
What to do
Avoid the combination where possible, and screen for latent tuberculosis before starting canakinumab. If used together, monitor closely for infection and stop canakinumab if a serious infection develops.
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 Canakinumab
- Adalimumab + Canakinumab Major
- Anakinra + Canakinumab Major
- Baricitinib + Canakinumab Major
- Basiliximab + Canakinumab Major
- Canakinumab + Etanercept Major
- Canakinumab + Golimumab Major
Frequently asked questions
Can I take Canakinumab with Tacrolimus?
MediHelp rates the interaction as major. Canakinumab 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. Canakinumab blocks interleukin-1 beta and is associated with an increased rate of serious infection. Adding tacrolimus, a calcineurin inhibitor, further suppresses immunity and may raise the risk of serious or opportunistic infection.
How serious is the interaction between Canakinumab 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: Avoid the combination where possible, and screen for latent tuberculosis before starting canakinumab. If used together, monitor closely for infection and stop canakinumab if a serious infection develops.
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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