Drug interactions
Potassium citrate / citric acid + Tacrolimus
Severity: Moderate
Potassium citrate / citric acid 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 reduces renal potassium excretion, and potassium supplements add to the potassium load. The combination can cause clinically significant hyperkalemia, especially in patients with renal impairment.
What this interaction means in plain words
Potassium citrate / citric acid 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.
Why it happens
Tacrolimus impairs distal tubular potassium secretion, and potassium citrate adds an exogenous potassium load, producing additive hyperkalemia.
What to do
Monitor serum potassium and renal function regularly, particularly after starting or changing the dose. Reduce or stop the potassium supplement if potassium rises.
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
Frequently asked questions
Can I take Potassium citrate / citric acid with Tacrolimus?
MediHelp rates the interaction as moderate. Potassium citrate / citric acid 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 reduces renal potassium excretion, and potassium supplements add to the potassium load. The combination can cause clinically significant hyperkalemia, especially in patients with renal impairment.
How serious is the interaction between Potassium citrate / citric acid 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 serum potassium and renal function regularly, particularly after starting or changing the dose. Reduce or stop the potassium supplement if potassium rises.
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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