Drug interactions
Flurbiprofen + Tacrolimus
Severity: Major
Flurbiprofen 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 impair kidney function, and using them together raises the chance of acute kidney injury and a rise in serum creatinine. Tacrolimus also causes hyperkalemia, which NSAIDs may worsen.
What this interaction means in plain words
Flurbiprofen 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.
Flurbiprofen belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
NSAIDs inhibit vasodilatory renal prostaglandins while tacrolimus causes afferent arteriolar vasoconstriction, producing additive reduction in renal blood flow.
What to do
Avoid the combination where possible and use a non-NSAID analgesic such as paracetamol. If unavoidable, use the lowest NSAID dose for the shortest time and monitor serum creatinine, potassium and tacrolimus trough levels.
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 Flurbiprofen
- Flurbiprofen + Ketorolac Contraindicated
- Flurbiprofen + Ketorolac intranasal Contraindicated
- Aceclofenac + Flurbiprofen Major
- Acemetacin + Flurbiprofen Major
- Acetylsalicylic acid + Flurbiprofen Major
- Alteplase + Flurbiprofen 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 Flurbiprofen with Tacrolimus?
MediHelp rates the interaction as major. Flurbiprofen 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 impair kidney function, and using them together raises the chance of acute kidney injury and a rise in serum creatinine. Tacrolimus also causes hyperkalemia, which NSAIDs may worsen.
How serious is the interaction between Flurbiprofen 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 and use a non-NSAID analgesic such as paracetamol. If unavoidable, use the lowest NSAID dose for the shortest time and monitor serum creatinine, potassium and tacrolimus trough levels.
What other medicines interact with Flurbiprofen?
MediHelp also lists interactions of Flurbiprofen with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Flurbiprofen page.
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