Drug interactions
Cyclophosphamide + Tacrolimus
Severity: Moderate
Cyclophosphamide 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
Cyclophosphamide and tacrolimus together produce additive immunosuppression, raising the risk of infection and cytopenias. The legacy CYP3A4 rationale is not well supported, but tacrolimus has a narrow therapeutic range and patients on chemotherapy often have changing organ function.
What this interaction means in plain words
Cyclophosphamide 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.
Cyclophosphamide belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive pharmacodynamic immunosuppression; a pharmacokinetic effect on tacrolimus is not established.
What to do
Monitor tacrolimus trough levels, renal function and blood counts. Adjust tacrolimus dose to trough concentrations and clinical status.
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 Cyclophosphamide
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 Cyclophosphamide with Tacrolimus?
MediHelp rates the interaction as moderate. Cyclophosphamide 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. Cyclophosphamide and tacrolimus together produce additive immunosuppression, raising the risk of infection and cytopenias. The legacy CYP3A4 rationale is not well supported, but tacrolimus has a narrow therapeutic range and patients on chemotherapy often have changing organ function.
How serious is the interaction between Cyclophosphamide 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 levels, renal function and blood counts. Adjust tacrolimus dose to trough concentrations and clinical status.
What other medicines interact with Cyclophosphamide?
MediHelp also lists interactions of Cyclophosphamide with, for example, Adenovirus types 4 and 7 live, Belatacept, Bendamustine. The full list is on the Cyclophosphamide page.
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