Drug interactions
Clotrimazole + Tacrolimus
Severity: Moderate
Clotrimazole 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
Clotrimazole troches have been reported to raise tacrolimus concentrations in transplant recipients, with associated toxicity such as nephrotoxicity and neurotoxicity. This is a recognised effect of azole antifungals on calcineurin inhibitors, and it is most relevant with oral troche use.
What this interaction means in plain words
Clotrimazole 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.
Clotrimazole belongs to Anti Fungals; Tacrolimus belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4 and possibly P-glycoprotein by clotrimazole reduces tacrolimus metabolism and efflux.
What to do
Measure tacrolimus trough levels when starting or stopping clotrimazole troches and adjust the tacrolimus dose accordingly. Monitor renal function and signs of neurotoxicity.
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 Clotrimazole
- Clotrimazole + Lomitapide Major
- Clotrimazole + Mavacamten Major
- Clotrimazole + Mobocertinib Major
- Clotrimazole + Voclosporin Major
- Bosutinib + Clotrimazole Moderate
- Cannabidiol + Clotrimazole Moderate
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 Clotrimazole with Tacrolimus?
MediHelp rates the interaction as moderate. Clotrimazole 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. Clotrimazole troches have been reported to raise tacrolimus concentrations in transplant recipients, with associated toxicity such as nephrotoxicity and neurotoxicity. This is a recognised effect of azole antifungals on calcineurin inhibitors, and it is most relevant with oral troche use.
How serious is the interaction between Clotrimazole 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: Measure tacrolimus trough levels when starting or stopping clotrimazole troches and adjust the tacrolimus dose accordingly. Monitor renal function and signs of neurotoxicity.
What other medicines interact with Clotrimazole?
MediHelp also lists interactions of Clotrimazole with, for example, Lomitapide, Mavacamten, Mobocertinib. The full list is on the Clotrimazole page.
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