Drug interactions
Isavuconazonium + Tacrolimus
Severity: Moderate
Isavuconazonium 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 is a moderate CYP3A4 inhibitor and increases tacrolimus exposure, with a risk of toxicity. Combined immunosuppression and antifungal therapy also requires attention to infection status.
What this interaction means in plain words
Isavuconazonium 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.
Isavuconazonium belongs to Anti Fungals; Tacrolimus belongs to Miscellaneous.
Why it happens
Inhibition of CYP3A4 (and P-glycoprotein) by isavuconazole reduces tacrolimus clearance.
What to do
Monitor tacrolimus trough levels when starting or stopping isavuconazonium and reduce the tacrolimus dose as needed. Monitor renal function and signs of tacrolimus toxicity.
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 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 Isavuconazonium
- Amobarbital + Isavuconazonium Contraindicated
- Apalutamide + Isavuconazonium Contraindicated
- Carbamazepine + Isavuconazonium Contraindicated
- Cisapride + Isavuconazonium Contraindicated
- Efavirenz + Isavuconazonium Contraindicated
- Enzalutamide + Isavuconazonium Contraindicated
Frequently asked questions
Can I take Isavuconazonium with Tacrolimus?
MediHelp rates the interaction as moderate. Isavuconazonium 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 is a moderate CYP3A4 inhibitor and increases tacrolimus exposure, with a risk of toxicity. Combined immunosuppression and antifungal therapy also requires attention to infection status.
How serious is the interaction between Isavuconazonium 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 or stopping isavuconazonium and reduce the tacrolimus dose as needed. Monitor renal function and signs of tacrolimus toxicity.
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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