Drug interactions
Rufinamide + Tacrolimus
Severity: Moderate
Rufinamide 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
Rufinamide is a weak CYP3A4 inducer and may modestly lower tacrolimus levels. The effect is probably small but matters with a narrow therapeutic index drug.
What this interaction means in plain words
Rufinamide 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.
Rufinamide belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Rufinamide weakly induces CYP3A4, increasing tacrolimus metabolism.
What to do
Check tacrolimus troughs after starting or stopping rufinamide and adjust the dose to target.
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 Rufinamide
- Carbamazepine + Rufinamide Moderate
- Desogestrel-ethinyl estradiol + Rufinamide Moderate
- Dronedarone + Rufinamide Moderate
- Esketamine + Rufinamide Moderate
- Ethinyl estradiol-drospirenone + Rufinamide Moderate
- Ethinyl estradiol-levonorgestrel + Rufinamide Moderate
Frequently asked questions
Can I take Rufinamide with Tacrolimus?
MediHelp rates the interaction as moderate. Rufinamide 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. Rufinamide is a weak CYP3A4 inducer and may modestly lower tacrolimus levels. The effect is probably small but matters with a narrow therapeutic index drug.
How serious is the interaction between Rufinamide 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: Check tacrolimus troughs after starting or stopping rufinamide and adjust the dose to target.
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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