Drug interactions
Ibuprofen + Tacrolimus
Severity: Major
Ibuprofen 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
Ibuprofen with tacrolimus increases the risk of acute kidney injury and may raise potassium. Both reduce renal blood flow through afferent arteriolar vasoconstriction.
What this interaction means in plain words
Ibuprofen 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.
Ibuprofen belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity from NSAID prostaglandin inhibition and calcineurin inhibitor-induced vasoconstriction.
What to do
Avoid NSAIDs in tacrolimus-treated patients where possible and use paracetamol. If used, monitor serum creatinine, potassium and tacrolimus trough levels closely.
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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Other interactions of Ibuprofen
- Ibuprofen + Ketorolac Contraindicated
- Ibuprofen + Ketorolac intranasal Contraindicated
- Acemetacin + Ibuprofen Major
- Alteplase + Ibuprofen Major
- Amiloride + Ibuprofen Major
- Apixaban + Ibuprofen 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 Ibuprofen with Tacrolimus?
MediHelp rates the interaction as major. Ibuprofen 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. Ibuprofen with tacrolimus increases the risk of acute kidney injury and may raise potassium. Both reduce renal blood flow through afferent arteriolar vasoconstriction.
How serious is the interaction between Ibuprofen 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 NSAIDs in tacrolimus-treated patients where possible and use paracetamol. If used, monitor serum creatinine, potassium and tacrolimus trough levels closely.
What other medicines interact with Ibuprofen?
MediHelp also lists interactions of Ibuprofen with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Ibuprofen page.
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