Drug interactions
Crizotinib + Tacrolimus
Severity: Major
Crizotinib and Tacrolimus: major interaction.
Last updated Sources: US FDA label
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
Crizotinib inhibits CYP3A4 and may increase tacrolimus concentrations, leading to nephrotoxicity, neurotoxicity and QT prolongation. Both drugs also have QT-prolonging potential.
What this interaction means in plain words
Crizotinib 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.
Crizotinib belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
CYP3A4 inhibition by crizotinib reduces tacrolimus clearance, with additive QT prolongation.
What to do
Monitor tacrolimus trough levels and reduce the dose as needed, along with renal function, ECG and electrolytes. Consider alternative therapy where possible.
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 Crizotinib
- Crizotinib + Flibanserin Contraindicated
- Crizotinib + Lomitapide Contraindicated
- Crizotinib + Lonafarnib Contraindicated
- Crizotinib + Pimozide Contraindicated
- Crizotinib + Saquinavir Contraindicated
- Crizotinib + Thioridazine Contraindicated
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 Crizotinib with Tacrolimus?
MediHelp rates the interaction as major. Crizotinib 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. Crizotinib inhibits CYP3A4 and may increase tacrolimus concentrations, leading to nephrotoxicity, neurotoxicity and QT prolongation. Both drugs also have QT-prolonging potential.
How serious is the interaction between Crizotinib 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 tacrolimus trough levels and reduce the dose as needed, along with renal function, ECG and electrolytes. Consider alternative therapy where possible.
What other medicines interact with Crizotinib?
MediHelp also lists interactions of Crizotinib with, for example, Flibanserin, Lomitapide, Lonafarnib. The full list is on the Crizotinib page.
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