Drug interactions
Melphalan + Tacrolimus
Severity: Major
Melphalan 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
Melphalan causes profound myelosuppression and tacrolimus suppresses T-cell function, so together the risk of serious infection is increased. Both can also affect renal function.
What this interaction means in plain words
Melphalan 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.
Melphalan belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive immunosuppression through bone marrow suppression and calcineurin inhibition.
What to do
Monitor blood counts, renal function and tacrolimus trough levels, and apply infection prophylaxis per protocol. Reassess the need for the combination at each cycle.
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 Melphalan
- Adenovirus types 4 and 7 live + Melphalan Contraindicated
- Bcg vaccine live + Melphalan Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Melphalan Contraindicated
- Measles mumps and rubella vaccine live + Melphalan Contraindicated
- Measles mumps and rubella vaccine + Melphalan Contraindicated
- Measles mumps rubella and varicella vaccine live + Melphalan Contraindicated
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 Melphalan with Tacrolimus?
MediHelp rates the interaction as major. Melphalan 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. Melphalan causes profound myelosuppression and tacrolimus suppresses T-cell function, so together the risk of serious infection is increased. Both can also affect renal function.
How serious is the interaction between Melphalan 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: Monitor blood counts, renal function and tacrolimus trough levels, and apply infection prophylaxis per protocol. Reassess the need for the combination at each cycle.
What other medicines interact with Melphalan?
MediHelp also lists interactions of Melphalan with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Influenza virus vaccine quadrivalent intranasal. The full list is on the Melphalan page.
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