Drug interactions
Isavuconazole + Tacrolimus
Severity: Moderate
Isavuconazole 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
Isavuconazole raises tacrolimus concentrations, increasing risk of nephrotoxicity, neurotoxicity and QT effects. The effect is clinically relevant because tacrolimus has a narrow therapeutic index.
What this interaction means in plain words
Isavuconazole 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.
Isavuconazole belongs to Anti Fungals; Tacrolimus belongs to Miscellaneous.
Why it happens
CYP3A4 inhibition by isavuconazole decreases tacrolimus clearance.
What to do
Monitor tacrolimus trough levels frequently and reduce the dose based on levels when isavuconazole is started; readjust after it is stopped.
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 Isavuconazole
- Carbamazepine + Isavuconazole Contraindicated
- Efavirenz + Isavuconazole Contraindicated
- Etravirine + Isavuconazole Contraindicated
- Isavuconazole + Ketoconazole Contraindicated
- Isavuconazole + Phenobarbitone Contraindicated
- Isavuconazole + Phenytoin Contraindicated
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 Isavuconazole with Tacrolimus?
MediHelp rates the interaction as moderate. Isavuconazole 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. Isavuconazole raises tacrolimus concentrations, increasing risk of nephrotoxicity, neurotoxicity and QT effects. The effect is clinically relevant because tacrolimus has a narrow therapeutic index.
How serious is the interaction between Isavuconazole 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 frequently and reduce the dose based on levels when isavuconazole is started; readjust after it is stopped.
What other medicines interact with Isavuconazole?
MediHelp also lists interactions of Isavuconazole with, for example, Carbamazepine, Efavirenz, Etravirine. The full list is on the Isavuconazole page.
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