Drug interactions
Pantoprazole + Tacrolimus
Severity: Moderate
Pantoprazole 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
Pantoprazole may raise tacrolimus blood concentrations, particularly in CYP2C19 intermediate or poor metabolizers. Higher levels can increase nephrotoxicity and neurotoxicity.
What this interaction means in plain words
Pantoprazole 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.
Pantoprazole belongs to Gastrointestinal Tract; Tacrolimus belongs to Miscellaneous.
Why it happens
Inhibition of CYP2C19-mediated tacrolimus metabolism.
What to do
Monitor tacrolimus trough levels when starting or stopping pantoprazole and adjust the dose as needed.
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 Pantoprazole
- Pantoprazole + Rilpivirine Contraindicated
- Acalabrutinib + Pantoprazole Major
- Atazanavir + Pantoprazole Major
- Dacomitinib + Pantoprazole Major
- Dasatinib + Pantoprazole Major
- Erlotinib + Pantoprazole Major
Frequently asked questions
Can I take Pantoprazole with Tacrolimus?
MediHelp rates the interaction as moderate. Pantoprazole 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. Pantoprazole may raise tacrolimus blood concentrations, particularly in CYP2C19 intermediate or poor metabolizers. Higher levels can increase nephrotoxicity and neurotoxicity.
How serious is the interaction between Pantoprazole 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 when starting or stopping pantoprazole and adjust the dose as needed.
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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