Drug interactions
Naproxen + Tacrolimus
Severity: Major
Naproxen 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 drugs can impair kidney function, and used together they raise the likelihood of acute kidney injury and a rise in serum creatinine. Tacrolimus constricts the afferent arteriole and NSAIDs remove the compensatory prostaglandin-mediated vasodilation.
What this interaction means in plain words
Naproxen 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.
Naproxen belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive nephrotoxicity through NSAID inhibition of renal prostaglandins combined with calcineurin-inhibitor-induced renal vasoconstriction.
What to do
Avoid the combination where possible and choose another analgesic such as paracetamol. If an NSAID is unavoidable, use the lowest dose for the shortest time 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 Naproxen
- Ketorolac intranasal + Naproxen Contraindicated
- Ketorolac + Naproxen Contraindicated
- Aceclofenac + Naproxen Major
- Acemetacin + Naproxen Major
- Acetylsalicylic acid + Naproxen Major
- Alteplase + Naproxen 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 Naproxen with Tacrolimus?
MediHelp rates the interaction as major. Naproxen 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 drugs can impair kidney function, and used together they raise the likelihood of acute kidney injury and a rise in serum creatinine. Tacrolimus constricts the afferent arteriole and NSAIDs remove the compensatory prostaglandin-mediated vasodilation.
How serious is the interaction between Naproxen 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 combination where possible and choose another analgesic such as paracetamol. If an NSAID is unavoidable, use the lowest dose for the shortest time and monitor serum creatinine, potassium and tacrolimus trough levels.
What other medicines interact with Naproxen?
MediHelp also lists interactions of Naproxen with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Naproxen page.
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