Drug interactions
Nefazodone + Tacrolimus
Severity: Major
Nefazodone 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
Nefazodone is a strong CYP3A4 inhibitor and can increase tacrolimus concentrations, leading to nephrotoxicity, neurotoxicity and QT prolongation.
What this interaction means in plain words
Nefazodone 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
Inhibition of CYP3A4-mediated tacrolimus metabolism.
What to do
Prefer another antidepressant with less CYP3A4 inhibition, such as sertraline. If combined, reduce the tacrolimus dose and monitor trough levels and renal function.
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 Nefazodone with Tacrolimus?
MediHelp rates the interaction as major. Nefazodone 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. Nefazodone is a strong CYP3A4 inhibitor and can increase tacrolimus concentrations, leading to nephrotoxicity, neurotoxicity and QT prolongation.
How serious is the interaction between Nefazodone 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: Prefer another antidepressant with less CYP3A4 inhibition, such as sertraline. If combined, reduce the tacrolimus dose and monitor trough levels and renal function.
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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