Drug interactions
Quinidine + Tacrolimus
Severity: Major
Quinidine 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
Quinidine may increase tacrolimus levels through P-gp and CYP3A4 inhibition, raising the risk of nephrotoxicity and neurotoxicity. Both drugs also prolong the QT interval, adding arrhythmic risk.
What this interaction means in plain words
Quinidine 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.
Quinidine belongs to Anti Parasitic; Tacrolimus belongs to Miscellaneous.
Why it happens
Quinidine inhibits P-gp and CYP3A4 handling of tacrolimus, combined with additive QT prolongation.
What to do
Monitor tacrolimus trough levels and renal function, and reduce the dose as needed. Obtain an ECG and correct electrolyte abnormalities.
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?
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Other interactions of Quinidine
- Adagrasib + Quinidine Contraindicated
- Arsenic trioxide + Quinidine Contraindicated
- Artemether / lumefantrine + Quinidine Contraindicated
- Chloroquine + Quinidine Contraindicated
- Dofetilide + Quinidine Contraindicated
- Dronedarone + Quinidine Contraindicated
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 Quinidine with Tacrolimus?
MediHelp rates the interaction as major. Quinidine 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. Quinidine may increase tacrolimus levels through P-gp and CYP3A4 inhibition, raising the risk of nephrotoxicity and neurotoxicity. Both drugs also prolong the QT interval, adding arrhythmic risk.
How serious is the interaction between Quinidine 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: Monitor tacrolimus trough levels and renal function, and reduce the dose as needed. Obtain an ECG and correct electrolyte abnormalities.
What other medicines interact with Quinidine?
MediHelp also lists interactions of Quinidine with, for example, Adagrasib, Arsenic trioxide, Artemether / lumefantrine. The full list is on the Quinidine page.
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