Drug interactions
Givinostat + Tacrolimus
Severity: Moderate
Givinostat 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
Givinostat can prolong the QT interval and tacrolimus has a similar effect, so the combination may add to arrhythmia risk. Givinostat is also a weak CYP3A4 inhibitor and may modestly raise tacrolimus concentrations, which has a narrow therapeutic index.
What this interaction means in plain words
Givinostat 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.
Givinostat belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation plus weak CYP3A4 inhibition by givinostat reducing tacrolimus metabolism.
What to do
Obtain ECGs at initiation and during concomitant use, and withhold givinostat if QTc exceeds 500 ms or rises markedly from baseline. Monitor tacrolimus trough levels and adjust the dose as needed.
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 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 Givinostat
- Abiraterone + Givinostat Major
- Amiodarone + Givinostat Major
- Amisulpride + Givinostat Major
- Amitriptyline + Givinostat Major
- Anagrelide + Givinostat Major
- Asenapine + Givinostat Major
Frequently asked questions
Can I take Givinostat with Tacrolimus?
MediHelp rates the interaction as moderate. Givinostat 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. Givinostat can prolong the QT interval and tacrolimus has a similar effect, so the combination may add to arrhythmia risk. Givinostat is also a weak CYP3A4 inhibitor and may modestly raise tacrolimus concentrations, which has a narrow therapeutic index.
How serious is the interaction between Givinostat 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: Obtain ECGs at initiation and during concomitant use, and withhold givinostat if QTc exceeds 500 ms or rises markedly from baseline. Monitor tacrolimus trough levels and adjust the dose as needed.
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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