Drug interactions
Levofloxacin + Tacrolimus
Severity: Moderate
Levofloxacin 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 agents have QT-prolonging potential, so combining them may increase the risk of torsades de pointes. Transplant patients often have electrolyte shifts that further raise this risk.
What this interaction means in plain words
Levofloxacin 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.
Levofloxacin belongs to Anti Bacterial; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive prolongation of cardiac repolarization via potassium channel effects.
What to do
Perform a baseline and follow-up ECG and keep potassium and magnesium in the normal range. Monitor tacrolimus trough levels and consider an alternative antibiotic if QTc becomes prolonged.
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 Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin 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 Levofloxacin with Tacrolimus?
MediHelp rates the interaction as moderate. Levofloxacin 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 agents have QT-prolonging potential, so combining them may increase the risk of torsades de pointes. Transplant patients often have electrolyte shifts that further raise this risk.
How serious is the interaction between Levofloxacin 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: Perform a baseline and follow-up ECG and keep potassium and magnesium in the normal range. Monitor tacrolimus trough levels and consider an alternative antibiotic if QTc becomes prolonged.
What other medicines interact with Levofloxacin?
MediHelp also lists interactions of Levofloxacin with, for example, Dronedarone, Ibutilide, Thioridazine. The full list is on the Levofloxacin page.
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