Drug interactions
Ciltacabtagene autoleucel + Tacrolimus
Severity: Major
Ciltacabtagene autoleucel 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
Tacrolimus is a calcineurin inhibitor that suppresses T-cell activation and may blunt the expansion and activity of CAR-T cells. This could reduce the antitumor effect and also adds to infection risk.
What this interaction means in plain words
Ciltacabtagene autoleucel 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.
Ciltacabtagene autoleucel belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
Calcineurin inhibition suppresses T-cell activation and proliferation, which may impair CAR-T cell function.
What to do
Avoid immunosuppressants such as tacrolimus around the time of CAR-T infusion unless needed to treat toxicity or transplant rejection. If it is required, involve the treating hematology team and monitor for infection and loss of response.
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 Ciltacabtagene autoleucel
Frequently asked questions
Can I take Ciltacabtagene autoleucel with Tacrolimus?
MediHelp rates the interaction as major. Ciltacabtagene autoleucel 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. Tacrolimus is a calcineurin inhibitor that suppresses T-cell activation and may blunt the expansion and activity of CAR-T cells. This could reduce the antitumor effect and also adds to infection risk.
How serious is the interaction between Ciltacabtagene autoleucel 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 immunosuppressants such as tacrolimus around the time of CAR-T infusion unless needed to treat toxicity or transplant rejection. If it is required, involve the treating hematology team and monitor for infection and loss of response.
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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