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Drug interactions

Fexinidazole + Tacrolimus

Severity: Major

Fexinidazole and Tacrolimus: major 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

Fexinidazole prolongs the QT interval, as does tacrolimus, so together they may increase the risk of torsades de pointes. Fexinidazole may also inhibit CYP3A4 and raise tacrolimus levels.

What this interaction means in plain words

Fexinidazole 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.

Evidence level: Low

Why it happens

Additive QT prolongation, plus CYP3A4 inhibition that reduces tacrolimus clearance.

What to do

Avoid the combination where possible. If it is unavoidable, monitor the ECG and electrolytes, and check tacrolimus trough levels and renal function.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Fexinidazole with Tacrolimus?

MediHelp rates the interaction as major. Fexinidazole 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. Fexinidazole prolongs the QT interval, as does tacrolimus, so together they may increase the risk of torsades de pointes. Fexinidazole may also inhibit CYP3A4 and raise tacrolimus levels.

How serious is the interaction between Fexinidazole 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 it is unavoidable, monitor the ECG and electrolytes, and check tacrolimus trough levels and renal function.

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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