Drug interactions
Metformin + Tacrolimus
Severity: Moderate
Metformin 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 is diabetogenic, impairing insulin secretion and increasing insulin resistance, which can worsen glycemic control despite metformin. Tacrolimus also may reduce renal function, which affects metformin safety.
What this interaction means in plain words
Metformin 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.
Metformin belongs to Endocrine; Tacrolimus belongs to Miscellaneous.
Why it happens
Pharmacodynamic antagonism: calcineurin inhibition reduces insulin secretion and sensitivity, opposing metformin's effect.
What to do
Monitor glucose and HbA1c, and check renal function regularly since tacrolimus can reduce eGFR. Intensify antidiabetic therapy if needed and hold metformin if renal function falls substantially.
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 Metformin
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 Metformin with Tacrolimus?
MediHelp rates the interaction as moderate. Metformin 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 is diabetogenic, impairing insulin secretion and increasing insulin resistance, which can worsen glycemic control despite metformin. Tacrolimus also may reduce renal function, which affects metformin safety.
How serious is the interaction between Metformin 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 glucose and HbA1c, and check renal function regularly since tacrolimus can reduce eGFR. Intensify antidiabetic therapy if needed and hold metformin if renal function falls substantially.
What other medicines interact with Metformin?
MediHelp also lists interactions of Metformin with, for example, Contrast media, Diatrizoate meglumine / diatrizoate, Diatrizoate. The full list is on the Metformin page.
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