Drug interactions
Meloxicam + Tacrolimus
Severity: Major
Meloxicam 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
Both agents can impair kidney function, and used together they raise the likelihood of acute kidney injury and a rise in serum creatinine. NSAID-related loss of vasodilatory prostaglandins adds to tacrolimus-induced afferent arteriolar constriction.
What this interaction means in plain words
Meloxicam 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.
Meloxicam belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive renal hemodynamic toxicity: NSAID inhibition of vasodilatory prostaglandins combined with calcineurin inhibitor-induced renal vasoconstriction.
What to do
Avoid the NSAID where possible and use paracetamol or another alternative. If unavoidable, use the shortest course and monitor serum creatinine, potassium and tacrolimus trough levels.
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 Meloxicam
- Ketorolac intranasal + Meloxicam Contraindicated
- Ketorolac + Meloxicam Contraindicated
- Aceclofenac + Meloxicam Major
- Acemetacin + Meloxicam Major
- Acetylsalicylic acid + Meloxicam Major
- Alteplase + Meloxicam 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 Meloxicam with Tacrolimus?
MediHelp rates the interaction as major. Meloxicam 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. Both agents can impair kidney function, and used together they raise the likelihood of acute kidney injury and a rise in serum creatinine. NSAID-related loss of vasodilatory prostaglandins adds to tacrolimus-induced afferent arteriolar constriction.
How serious is the interaction between Meloxicam 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: Avoid the NSAID where possible and use paracetamol or another alternative. If unavoidable, use the shortest course and monitor serum creatinine, potassium and tacrolimus trough levels.
What other medicines interact with Meloxicam?
MediHelp also lists interactions of Meloxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Meloxicam page.
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