Drug interactions
Loperamide + Tacrolimus
Severity: Moderate
Loperamide 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
Tacrolimus prolongs the QT interval and inhibits P-glycoprotein, which may raise loperamide exposure and its cardiac and central effects. Diarrhea itself can also alter tacrolimus levels.
What this interaction means in plain words
Loperamide 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.
Loperamide belongs to Gastrointestinal Tract; Tacrolimus belongs to Miscellaneous.
Why it happens
P-glycoprotein inhibition raising loperamide levels, plus additive QT prolongation.
What to do
Use loperamide at labeled doses and avoid prolonged use. Monitor ECG, electrolytes and tacrolimus trough levels during diarrhea.
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 Loperamide
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 Loperamide with Tacrolimus?
MediHelp rates the interaction as moderate. Loperamide 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. Tacrolimus prolongs the QT interval and inhibits P-glycoprotein, which may raise loperamide exposure and its cardiac and central effects. Diarrhea itself can also alter tacrolimus levels.
How serious is the interaction between Loperamide 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: Use loperamide at labeled doses and avoid prolonged use. Monitor ECG, electrolytes and tacrolimus trough levels during diarrhea.
What other medicines interact with Loperamide?
MediHelp also lists interactions of Loperamide with, for example, Amiodarone, Amisulpride, Anagrelide. The full list is on the Loperamide page.
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