Drug interactions
Rabies vaccine + Tacrolimus
Severity: Major
Rabies vaccine 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
Tacrolimus may reduce the antibody response to rabies vaccine, which is a concern because rabies is almost always fatal once symptoms develop. The vaccine is inactivated and should be given when indicated.
What this interaction means in plain words
Rabies vaccine 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.
Why it happens
Calcineurin inhibition suppresses T-cell dependent antibody production.
What to do
Give the full series, including immunoglobulin for post-exposure prophylaxis, and check rabies neutralizing antibody titers afterward. Pre-exposure vaccination should be complete before travel.
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 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 Rabies vaccine with Tacrolimus?
MediHelp rates the interaction as major. Rabies vaccine 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. Tacrolimus may reduce the antibody response to rabies vaccine, which is a concern because rabies is almost always fatal once symptoms develop. The vaccine is inactivated and should be given when indicated.
How serious is the interaction between Rabies vaccine 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: Give the full series, including immunoglobulin for post-exposure prophylaxis, and check rabies neutralizing antibody titers afterward. Pre-exposure vaccination should be complete before travel.
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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