Drug interactions
Oxcarbazepine + Tacrolimus
Severity: Major
Oxcarbazepine 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
Oxcarbazepine may lower tacrolimus blood levels, risking under-immunosuppression and graft rejection. Levels can rise again after oxcarbazepine is stopped.
What this interaction means in plain words
Oxcarbazepine 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.
Oxcarbazepine belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Oxcarbazepine induces intestinal and hepatic CYP3A4, increasing tacrolimus metabolism.
What to do
Measure tacrolimus trough concentrations frequently after starting, changing or stopping oxcarbazepine and adjust the dose.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Oxcarbazepine and Tacrolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Oxcarbazepine
- Cabotegravir + Oxcarbazepine Contraindicated
- Oxcarbazepine + Rilpivirine Contraindicated
- Artemether / lumefantrine + Oxcarbazepine Major
- Atazanavir + Oxcarbazepine Major
- Benzhydrocodone / acetaminophen + Oxcarbazepine Major
- Bictegravir + Oxcarbazepine 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 Oxcarbazepine with Tacrolimus?
MediHelp rates the interaction as major. Oxcarbazepine 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. Oxcarbazepine may lower tacrolimus blood levels, risking under-immunosuppression and graft rejection. Levels can rise again after oxcarbazepine is stopped.
How serious is the interaction between Oxcarbazepine 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: Measure tacrolimus trough concentrations frequently after starting, changing or stopping oxcarbazepine and adjust the dose.
What other medicines interact with Oxcarbazepine?
MediHelp also lists interactions of Oxcarbazepine with, for example, Cabotegravir, Rilpivirine, Artemether / lumefantrine. The full list is on the Oxcarbazepine page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
