Drug interactions
Conivaptan + Tacrolimus
Severity: Moderate
Conivaptan 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
Conivaptan is a CYP3A4 inhibitor and can raise tacrolimus blood concentrations. Higher exposure increases the risk of nephrotoxicity, neurotoxicity and other tacrolimus adverse effects, particularly given the narrow therapeutic index.
What this interaction means in plain words
Conivaptan 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.
Why it happens
Conivaptan inhibits CYP3A4-mediated metabolism of tacrolimus, reducing its clearance.
What to do
Monitor tacrolimus trough concentrations and renal function when conivaptan is started or stopped, and reduce the tacrolimus dose if levels rise.
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 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 Conivaptan with Tacrolimus?
MediHelp rates the interaction as moderate. Conivaptan 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. Conivaptan is a CYP3A4 inhibitor and can raise tacrolimus blood concentrations. Higher exposure increases the risk of nephrotoxicity, neurotoxicity and other tacrolimus adverse effects, particularly given the narrow therapeutic index.
How serious is the interaction between Conivaptan 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 tacrolimus trough concentrations and renal function when conivaptan is started or stopped, and reduce the tacrolimus dose if levels rise.
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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