Drug interactions
Cisplatin + Tacrolimus
Severity: Major
Cisplatin and Tacrolimus: major interaction.
Last updated Sources: Health Canada product monograph
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
Both drugs are nephrotoxic, and cisplatin can also cause ototoxicity, so the combination can accelerate kidney injury. Reduced renal function may in turn raise tacrolimus exposure and its toxicity.
What this interaction means in plain words
Cisplatin 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.
Cisplatin belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity from tubular injury by cisplatin and afferent arteriolar vasoconstriction by tacrolimus.
What to do
Monitor serum creatinine, electrolytes including magnesium, and tacrolimus trough levels closely. Adjust the tacrolimus dose and ensure hydration, and consider alternatives to cisplatin if renal function declines.
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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References
Other interactions of Cisplatin
- Cidofovir + Cisplatin Contraindicated
- Adefovir + Cisplatin Major
- Adenovirus types 4 and 7 live + Cisplatin Major
- Amikacin + Cisplatin Major
- Amphotericin b deoxycholate + Cisplatin Major
- Amphotericin b + Cisplatin Major
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 Cisplatin with Tacrolimus?
MediHelp rates the interaction as major. Cisplatin 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. Both drugs are nephrotoxic, and cisplatin can also cause ototoxicity, so the combination can accelerate kidney injury. Reduced renal function may in turn raise tacrolimus exposure and its toxicity.
How serious is the interaction between Cisplatin 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: Monitor serum creatinine, electrolytes including magnesium, and tacrolimus trough levels closely. Adjust the tacrolimus dose and ensure hydration, and consider alternatives to cisplatin if renal function declines.
What other medicines interact with Cisplatin?
MediHelp also lists interactions of Cisplatin with, for example, Cidofovir, Adefovir, Adenovirus types 4 and 7 live. The full list is on the Cisplatin page.
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