Drug interactions
Dapagliflozin-metformin + Tacrolimus
Severity: Moderate
Dapagliflozin-metformin 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
Tacrolimus is diabetogenic and can raise blood glucose, reducing the effectiveness of dapagliflozin-metformin. It is also nephrotoxic, which increases the risk of metformin accumulation, and SGLT2 inhibitors can add to genitourinary infection risk in immunosuppressed patients.
What this interaction means in plain words
Dapagliflozin-metformin 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.
Dapagliflozin-metformin belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Tacrolimus impairs insulin secretion and sensitivity (pharmacodynamic antagonism) and may reduce renal function, affecting metformin clearance.
What to do
Monitor glucose, HbA1c and renal function regularly. Adjust the antidiabetic regimen and stop metformin if renal function falls significantly.
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 Dapagliflozin-metformin
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 Dapagliflozin-metformin with Tacrolimus?
MediHelp rates the interaction as moderate. Dapagliflozin-metformin 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. Tacrolimus is diabetogenic and can raise blood glucose, reducing the effectiveness of dapagliflozin-metformin. It is also nephrotoxic, which increases the risk of metformin accumulation, and SGLT2 inhibitors can add to genitourinary infection risk in immunosuppressed patients.
How serious is the interaction between Dapagliflozin-metformin 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 glucose, HbA1c and renal function regularly. Adjust the antidiabetic regimen and stop metformin if renal function falls significantly.
What other medicines interact with Dapagliflozin-metformin?
MediHelp also lists interactions of Dapagliflozin-metformin with, for example, Contrast media, Diatrizoate, Diatrizoate meglumine / diatrizoate. The full list is on the Dapagliflozin-metformin page.
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