Drug interactions
Clozapine + Tacrolimus
Severity: Moderate
Clozapine 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
Both drugs can prolong the QT interval, so concurrent use may raise the risk of ventricular arrhythmia. Clozapine's bone marrow toxicity and tacrolimus use in transplant patients also complicate management.
What this interaction means in plain words
Clozapine 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.
Clozapine belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation.
What to do
Monitor ECG and correct electrolytes, especially magnesium and potassium. Follow tacrolimus trough levels and blood counts.
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 Clozapine
- Clozapine + Deferiprone Contraindicated
- Clozapine + Irinotecan Contraindicated
- Clozapine + Pimozide Contraindicated
- Clozapine + Thioridazine Contraindicated
- Acalabrutinib + Clozapine Major
- Adagrasib + Clozapine 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 Clozapine with Tacrolimus?
MediHelp rates the interaction as moderate. Clozapine 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. Both drugs can prolong the QT interval, so concurrent use may raise the risk of ventricular arrhythmia. Clozapine's bone marrow toxicity and tacrolimus use in transplant patients also complicate management.
How serious is the interaction between Clozapine 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 ECG and correct electrolytes, especially magnesium and potassium. Follow tacrolimus trough levels and blood counts.
What other medicines interact with Clozapine?
MediHelp also lists interactions of Clozapine with, for example, Deferiprone, Irinotecan, Pimozide. The full list is on the Clozapine page.
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