Drug interactions
Sarilumab + Tacrolimus
Severity: Moderate
Sarilumab 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
IL-6 blockade can reverse suppression of CYP450 enzymes, increasing metabolism of substrates such as tacrolimus. Tacrolimus levels may fall after sarilumab is started and rise after it is stopped.
What this interaction means in plain words
Sarilumab 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.
Sarilumab belongs to Musculoskeletal; Tacrolimus belongs to Miscellaneous.
Why it happens
Blockade of IL-6 restores CYP3A4 expression and activity.
What to do
Check tacrolimus trough levels when starting or stopping sarilumab and adjust the dose accordingly.
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 Sarilumab
Frequently asked questions
Can I take Sarilumab with Tacrolimus?
MediHelp rates the interaction as moderate. Sarilumab 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. IL-6 blockade can reverse suppression of CYP450 enzymes, increasing metabolism of substrates such as tacrolimus. Tacrolimus levels may fall after sarilumab is started and rise after it is stopped.
How serious is the interaction between Sarilumab 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 trough levels when starting or stopping sarilumab and adjust the dose accordingly.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
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