Drug interactions
Nafcillin + Tacrolimus
Severity: Major
Nafcillin 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
Nafcillin can lower tacrolimus concentrations, with case reports of subtherapeutic levels during therapy. This may lead to rejection if not recognised.
What this interaction means in plain words
Nafcillin 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.
Why it happens
Induction of CYP3A4 by nafcillin increases tacrolimus metabolism.
What to do
Use an alternative antibiotic if feasible; otherwise monitor tacrolimus troughs closely and raise the dose, then reduce it after nafcillin is stopped.
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 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 Nafcillin with Tacrolimus?
MediHelp rates the interaction as major. Nafcillin 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. Nafcillin can lower tacrolimus concentrations, with case reports of subtherapeutic levels during therapy. This may lead to rejection if not recognised.
How serious is the interaction between Nafcillin 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: Use an alternative antibiotic if feasible; otherwise monitor tacrolimus troughs closely and raise the dose, then reduce it after nafcillin is stopped.
What other medicines interact with Tacrolimus?
MediHelp also lists interactions of Tacrolimus with, for example, Adenovirus types 4 and 7 live, Bcg vaccine live, Cidofovir. The full list is on the Tacrolimus page.
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