Drug interactions
Omeprazole + Tacrolimus
Severity: Moderate
Omeprazole 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
Omeprazole can increase tacrolimus blood concentrations, especially in CYP2C19 intermediate or poor metabolizers who also have CYP3A5 non-expressor status. Elevated tacrolimus raises the risk of nephrotoxicity and neurotoxicity.
What this interaction means in plain words
Omeprazole 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.
Omeprazole belongs to Gastrointestinal Tract; Tacrolimus belongs to Miscellaneous.
Why it happens
Omeprazole inhibits CYP2C19 and CYP3A4 metabolism of tacrolimus.
What to do
Monitor tacrolimus trough levels and renal function when omeprazole is started, stopped or changed, and adjust the tacrolimus dose accordingly.
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 Omeprazole
- Mavacamten + Omeprazole Contraindicated
- Omeprazole + Rilpivirine Contraindicated
- Acalabrutinib + Omeprazole Major
- Atazanavir + Omeprazole Major
- Citalopram + Omeprazole Major
- Clopidogrel + Omeprazole 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 Omeprazole with Tacrolimus?
MediHelp rates the interaction as moderate. Omeprazole 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. Omeprazole can increase tacrolimus blood concentrations, especially in CYP2C19 intermediate or poor metabolizers who also have CYP3A5 non-expressor status. Elevated tacrolimus raises the risk of nephrotoxicity and neurotoxicity.
How serious is the interaction between Omeprazole 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 tacrolimus trough levels and renal function when omeprazole is started, stopped or changed, and adjust the tacrolimus dose accordingly.
What other medicines interact with Omeprazole?
MediHelp also lists interactions of Omeprazole with, for example, Mavacamten, Rilpivirine, Acalabrutinib. The full list is on the Omeprazole page.
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