Drug interactions
Hydrocortisone + Tacrolimus
Severity: Moderate
Hydrocortisone 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
Hydrocortisone may modestly lower tacrolimus concentrations through CYP3A4 induction, and the two drugs are commonly used together for immunosuppression. Changes in steroid dose can shift tacrolimus levels, and the combination adds to infection and hyperglycemia risk.
What this interaction means in plain words
Hydrocortisone 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.
Hydrocortisone belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Corticosteroid-mediated CYP3A4 induction can lower tacrolimus exposure, with possible P-glycoprotein effects on both drugs; the immunosuppressive effects are also additive.
What to do
Monitor tacrolimus trough levels when starting, stopping or changing steroid doses, and adjust the tacrolimus dose accordingly. Monitor for infection and glucose elevation.
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 Hydrocortisone 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 7 days on the web. No card needed.
Other interactions of Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone 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 Hydrocortisone with Tacrolimus?
MediHelp rates the interaction as moderate. Hydrocortisone 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. Hydrocortisone may modestly lower tacrolimus concentrations through CYP3A4 induction, and the two drugs are commonly used together for immunosuppression. Changes in steroid dose can shift tacrolimus levels, and the combination adds to infection and hyperglycemia risk.
How serious is the interaction between Hydrocortisone 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: Monitor tacrolimus trough levels when starting, stopping or changing steroid doses, and adjust the tacrolimus dose accordingly. Monitor for infection and glucose elevation.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone 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.
