Drug interactions
Glecaprevir / pibrentasvir + Tacrolimus
Severity: Moderate
Glecaprevir / pibrentasvir 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
Glecaprevir and pibrentasvir inhibit P-glycoprotein and other transporters and may raise tacrolimus exposure. In addition, tacrolimus levels can shift as hepatic inflammation resolves during hepatitis C clearance, creating a risk of toxicity or under-immunosuppression.
What this interaction means in plain words
Glecaprevir / pibrentasvir 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.
Why it happens
Inhibition of P-glycoprotein (and intestinal efflux/CYP3A4 effects) by glecaprevir/pibrentasvir increases tacrolimus absorption and exposure.
What to do
Measure tacrolimus trough levels before starting and frequently during and after hepatitis C treatment, adjusting the dose to target range. Monitor renal function and signs of tacrolimus toxicity.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Glecaprevir / pibrentasvir and Tacrolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
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 Glecaprevir / pibrentasvir with Tacrolimus?
MediHelp rates the interaction as moderate. Glecaprevir / pibrentasvir 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. Glecaprevir and pibrentasvir inhibit P-glycoprotein and other transporters and may raise tacrolimus exposure. In addition, tacrolimus levels can shift as hepatic inflammation resolves during hepatitis C clearance, creating a risk of toxicity or under-immunosuppression.
How serious is the interaction between Glecaprevir / pibrentasvir 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: Measure tacrolimus trough levels before starting and frequently during and after hepatitis C treatment, adjusting the dose to target range. Monitor renal function and signs of tacrolimus toxicity.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
