Drug interactions
Etodolac + Tacrolimus
Severity: Major
Etodolac and Tacrolimus: major interaction.
Last updated Sources: UK SmPC
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
Both drugs can reduce renal perfusion, so combining them raises the chance of acute kidney injury and a rise in creatinine. Hyperkalemia may also be worsened.
What this interaction means in plain words
Etodolac 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.
Etodolac belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
Tacrolimus causes afferent arteriolar vasoconstriction and NSAIDs block vasodilatory prostaglandins, producing additive reduction in glomerular blood flow.
What to do
Avoid the combination where possible; if needed, use the shortest NSAID course and monitor serum creatinine, potassium and tacrolimus trough levels closely.
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
- Etopan XL 600 mg Film-coated prolonged release tablets - SmPC sections 4.3/4.5 (names the partner; "hrotoxicity. Anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs): Increased risk of gastrointestinal bleeding (see section 4.4). Tacrolimus") — electronic medicines compendium (UK SmPC)
Other interactions of Etodolac
- Etodolac + Ketorolac Contraindicated
- Etodolac + Ketorolac intranasal Contraindicated
- Aceclofenac + Etodolac Major
- Acemetacin + Etodolac Major
- Acetylsalicylic acid + Etodolac Major
- Alteplase + Etodolac Major
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 Etodolac with Tacrolimus?
MediHelp rates the interaction as major. Etodolac 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. Both drugs can reduce renal perfusion, so combining them raises the chance of acute kidney injury and a rise in creatinine. Hyperkalemia may also be worsened.
How serious is the interaction between Etodolac 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: Avoid the combination where possible; if needed, use the shortest NSAID course and monitor serum creatinine, potassium and tacrolimus trough levels closely.
What other medicines interact with Etodolac?
MediHelp also lists interactions of Etodolac with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Etodolac page.
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