Drug interactions
Erythromycin lactobionate + Tacrolimus
Severity: Major
Erythromycin lactobionate 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
Intravenous erythromycin inhibits CYP3A4 and can quickly raise tacrolimus concentrations, with a risk of kidney injury and neurotoxicity. Both drugs also prolong the QT interval.
What this interaction means in plain words
Erythromycin lactobionate 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.
Erythromycin lactobionate belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
CYP3A4 and P-glycoprotein inhibition by erythromycin reduces tacrolimus clearance, along with additive QT prolongation.
What to do
Choose an alternative antibiotic when possible. If it is required, reduce the tacrolimus dose, monitor trough levels and renal function closely, and check the ECG.
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 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
Other interactions of Erythromycin lactobionate
- Cisapride + Erythromycin lactobionate Contraindicated
- Dihydroergotamine + Erythromycin lactobionate Contraindicated
- Dronedarone + Erythromycin lactobionate Contraindicated
- Eletriptan + Erythromycin lactobionate Contraindicated
- Ergotamine + Erythromycin lactobionate Contraindicated
- Erythromycin lactobionate + Flibanserin Contraindicated
Frequently asked questions
Can I take Erythromycin lactobionate with Tacrolimus?
MediHelp rates the interaction as major. Erythromycin lactobionate 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. Intravenous erythromycin inhibits CYP3A4 and can quickly raise tacrolimus concentrations, with a risk of kidney injury and neurotoxicity. Both drugs also prolong the QT interval.
How serious is the interaction between Erythromycin lactobionate 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: Choose an alternative antibiotic when possible. If it is required, reduce the tacrolimus dose, monitor trough levels and renal function closely, and check the ECG.
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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