Drug interactions
Istradefylline + Tacrolimus
Severity: Moderate
Istradefylline 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
At 40 mg daily istradefylline raises exposure to CYP3A4 and P-glycoprotein substrates, and tacrolimus is both. Higher tacrolimus levels may cause toxicity, whereas this effect was not seen at 20 mg daily.
What this interaction means in plain words
Istradefylline 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.
Istradefylline belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Dose-dependent inhibition of CYP3A4 and P-glycoprotein by istradefylline.
What to do
Monitor tacrolimus trough levels when istradefylline is started, especially at 40 mg daily, and reduce the tacrolimus dose as required. Prefer the 20 mg dose where clinically appropriate.
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 Istradefylline
Frequently asked questions
Can I take Istradefylline with Tacrolimus?
MediHelp rates the interaction as moderate. Istradefylline 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. At 40 mg daily istradefylline raises exposure to CYP3A4 and P-glycoprotein substrates, and tacrolimus is both. Higher tacrolimus levels may cause toxicity, whereas this effect was not seen at 20 mg daily.
How serious is the interaction between Istradefylline 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 istradefylline is started, especially at 40 mg daily, and reduce the tacrolimus dose as required. Prefer the 20 mg dose where clinically appropriate.
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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