Drug interactions
Nintedanib + Tacrolimus
Severity: Moderate
Nintedanib 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 a P-glycoprotein substrate and can compete for efflux, which may raise nintedanib exposure. Higher nintedanib levels could increase gastrointestinal effects, liver enzyme elevations and bleeding risk.
What this interaction means in plain words
Nintedanib 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.
Nintedanib belongs to Oncology; Tacrolimus belongs to Miscellaneous.
Why it happens
Competition at intestinal P-glycoprotein efflux may increase nintedanib absorption and exposure.
What to do
Monitor for diarrhea, nausea and liver enzyme elevations, and check liver tests regularly during combined use. Interrupt or reduce the nintedanib dose if adverse effects develop.
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 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
Other interactions of Nintedanib
- Amiodarone + Nintedanib Moderate
- Apixaban + Nintedanib Moderate
- Argatroban + Nintedanib Moderate
- Azithromycin + Nintedanib Moderate
- Carbamazepine + Nintedanib Moderate
- Carvedilol + Nintedanib Moderate
Frequently asked questions
Can I take Nintedanib with Tacrolimus?
MediHelp rates the interaction as moderate. Nintedanib 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 a P-glycoprotein substrate and can compete for efflux, which may raise nintedanib exposure. Higher nintedanib levels could increase gastrointestinal effects, liver enzyme elevations and bleeding risk.
How serious is the interaction between Nintedanib 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 for diarrhea, nausea and liver enzyme elevations, and check liver tests regularly during combined use. Interrupt or reduce the nintedanib dose if adverse effects develop.
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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