Drug interactions
Lithium + Tacrolimus
Severity: Moderate
Lithium 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 can affect cardiac repolarization, so QT prolongation may be additive. Tacrolimus is also nephrotoxic and may reduce renal function, which can raise lithium concentrations and toxicity.
What this interaction means in plain words
Lithium 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.
Lithium belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation, plus possible reduction in lithium clearance from tacrolimus-related nephrotoxicity.
What to do
Monitor serum lithium, creatinine and electrolytes regularly, and obtain an ECG at baseline and after dose changes. Reduce the lithium dose if levels rise or renal function declines.
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 Lithium
- Lithium + Thioridazine Contraindicated
- Lithium + Vandetanib Contraindicated
- Aceclofenac + Lithium Major
- Acemetacin + Lithium Major
- Amisulpride + Lithium Major
- Amlodipine-benazepril + Lithium 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 Lithium with Tacrolimus?
MediHelp rates the interaction as moderate. Lithium 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 can affect cardiac repolarization, so QT prolongation may be additive. Tacrolimus is also nephrotoxic and may reduce renal function, which can raise lithium concentrations and toxicity.
How serious is the interaction between Lithium 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 serum lithium, creatinine and electrolytes regularly, and obtain an ECG at baseline and after dose changes. Reduce the lithium dose if levels rise or renal function declines.
What other medicines interact with Lithium?
MediHelp also lists interactions of Lithium with, for example, Thioridazine, Vandetanib, Aceclofenac. The full list is on the Lithium page.
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