Drug interactions
Dexamethasone + Tacrolimus
Severity: Moderate
Dexamethasone 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
Dexamethasone can induce CYP3A4 and P-glycoprotein, which may lower tacrolimus blood concentrations and raise the risk of under-immunosuppression. Tacrolimus levels can then rise again when steroid doses are tapered. Both drugs are immunosuppressive, adding to infection risk.
What this interaction means in plain words
Dexamethasone 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.
Dexamethasone belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Dexamethasone induces CYP3A4 and P-glycoprotein, increasing tacrolimus clearance.
What to do
Monitor tacrolimus trough concentrations when starting, changing or stopping dexamethasone and adjust the dose. Watch for infection and graft function.
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 Dexamethasone
- Bcg vaccine live + Dexamethasone Contraindicated
- Dexamethasone + Mifepristone Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexamethasone + Smallpox vaccine live Contraindicated
- Dexamethasone + Varicella virus vaccine live Contraindicated
- Dexamethasone + Yellow fever vaccine 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 Dexamethasone with Tacrolimus?
MediHelp rates the interaction as moderate. Dexamethasone 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. Dexamethasone can induce CYP3A4 and P-glycoprotein, which may lower tacrolimus blood concentrations and raise the risk of under-immunosuppression. Tacrolimus levels can then rise again when steroid doses are tapered. Both drugs are immunosuppressive, adding to infection risk.
How serious is the interaction between Dexamethasone 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 when starting, changing or stopping dexamethasone and adjust the dose. Watch for infection and graft function.
What other medicines interact with Dexamethasone?
MediHelp also lists interactions of Dexamethasone with, for example, Bcg vaccine live, Mifepristone, Rilpivirine. The full list is on the Dexamethasone page.
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