Drug interactions
Ibutilide + Tacrolimus
Severity: Major
Ibutilide 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
Both drugs can prolong the QT interval, and ibutilide in particular carries a high risk of torsade de pointes. Tacrolimus adds to this risk, especially when electrolyte disturbances are present, which are common in transplant patients.
What this interaction means in plain words
Ibutilide 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.
Ibutilide belongs to Cardiovascular; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive prolongation of cardiac repolarization (QT interval) through potassium channel effects.
What to do
Avoid the combination where an alternative cardioversion strategy exists. If ibutilide is essential, correct potassium and magnesium first and monitor the ECG continuously during and after the infusion.
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 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 Ibutilide
- Amiodarone + Ibutilide Contraindicated
- Amisulpride + Ibutilide Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Clarithromycin + Ibutilide Contraindicated
- Desipramine + Ibutilide Contraindicated
- Dolasetron + Ibutilide Contraindicated
Frequently asked questions
Can I take Ibutilide with Tacrolimus?
MediHelp rates the interaction as major. Ibutilide 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 prolong the QT interval, and ibutilide in particular carries a high risk of torsade de pointes. Tacrolimus adds to this risk, especially when electrolyte disturbances are present, which are common in transplant patients.
How serious is the interaction between Ibutilide 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 an alternative cardioversion strategy exists. If ibutilide is essential, correct potassium and magnesium first and monitor the ECG continuously during and after the infusion.
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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