Drug interactions
Imatinib + Tacrolimus
Severity: Moderate
Imatinib 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
Both drugs are CYP3A4 substrates and imatinib inhibits CYP3A4, which may raise tacrolimus concentrations and increase nephrotoxicity and neurotoxicity. Tacrolimus has a narrow therapeutic index.
What this interaction means in plain words
Imatinib 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.
Imatinib belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Imatinib inhibition of CYP3A4 reduces tacrolimus metabolism, with possible P-glycoprotein competition.
What to do
Monitor tacrolimus trough levels and renal function, adjusting dose as needed. Check levels after starting or stopping imatinib.
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 Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Benzhydrocodone / acetaminophen + Imatinib 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 Imatinib with Tacrolimus?
MediHelp rates the interaction as moderate. Imatinib 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. Both drugs are CYP3A4 substrates and imatinib inhibits CYP3A4, which may raise tacrolimus concentrations and increase nephrotoxicity and neurotoxicity. Tacrolimus has a narrow therapeutic index.
How serious is the interaction between Imatinib 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 and renal function, adjusting dose as needed. Check levels after starting or stopping imatinib.
What other medicines interact with Imatinib?
MediHelp also lists interactions of Imatinib with, for example, Lomitapide, Lonafarnib, Amobarbital. The full list is on the Imatinib page.
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