Drug interactions
Nilotinib + Tacrolimus
Severity: Major
Nilotinib 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 prolong the QT interval, and nilotinib inhibits CYP3A4, which may increase tacrolimus levels. This raises the risk of arrhythmia as well as tacrolimus nephrotoxicity and neurotoxicity.
What this interaction means in plain words
Nilotinib 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.
Nilotinib belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation plus CYP3A4 and P-glycoprotein inhibition by nilotinib reducing tacrolimus clearance.
What to do
Monitor tacrolimus trough concentrations and adjust the dose, and check ECG and electrolytes regularly. Choose an alternative when feasible.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib 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 Nilotinib with Tacrolimus?
MediHelp rates the interaction as major. Nilotinib 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 prolong the QT interval, and nilotinib inhibits CYP3A4, which may increase tacrolimus levels. This raises the risk of arrhythmia as well as tacrolimus nephrotoxicity and neurotoxicity.
How serious is the interaction between Nilotinib 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 tacrolimus trough concentrations and adjust the dose, and check ECG and electrolytes regularly. Choose an alternative when feasible.
What other medicines interact with Nilotinib?
MediHelp also lists interactions of Nilotinib with, for example, Amiodarone, Arsenic trioxide, Disopyramide. The full list is on the Nilotinib page.
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