Drug interactions
Lefamulin + Tacrolimus
Severity: Major
Lefamulin 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
Lefamulin inhibits CYP3A4 and may raise tacrolimus concentrations, increasing nephrotoxicity, neurotoxicity and QT prolongation risk. Both agents can prolong the QT interval. Oral lefamulin labeling contraindicates use with sensitive CYP3A substrates that prolong QT.
What this interaction means in plain words
Lefamulin 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.
Lefamulin belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
CYP3A4 inhibition raises tacrolimus levels, with additive QT prolongation.
What to do
Use an alternative antibiotic where possible. If combined, monitor tacrolimus troughs, renal function, electrolytes and ECG.
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 Lefamulin
- Lefamulin + Methadone Contraindicated
- Lefamulin + Pimavanserin Contraindicated
- Lefamulin + Pimozide Contraindicated
- Lefamulin + Quinidine Contraindicated
- Alfuzosin + Lefamulin Major
- Amiodarone + Lefamulin Major
Frequently asked questions
Can I take Lefamulin with Tacrolimus?
MediHelp rates the interaction as major. Lefamulin 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. Lefamulin inhibits CYP3A4 and may raise tacrolimus concentrations, increasing nephrotoxicity, neurotoxicity and QT prolongation risk. Both agents can prolong the QT interval. Oral lefamulin labeling contraindicates use with sensitive CYP3A substrates that prolong QT.
How serious is the interaction between Lefamulin 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: Use an alternative antibiotic where possible. If combined, monitor tacrolimus troughs, renal function, electrolytes and ECG.
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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