Drug interactions
Secobarbital + Tacrolimus
Severity: Major
Secobarbital 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
Secobarbital can lower tacrolimus blood concentrations, risking subtherapeutic immunosuppression and graft rejection. The induction develops over days to weeks and fades slowly after the barbiturate is stopped.
What this interaction means in plain words
Secobarbital 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.
Secobarbital belongs to Central Nervous System; Tacrolimus belongs to Miscellaneous.
Why it happens
Barbiturate induction of intestinal and hepatic CYP3A4 (and P-glycoprotein) increases tacrolimus clearance.
What to do
Measure tacrolimus trough levels frequently when starting or stopping secobarbital and adjust the dose accordingly. Prefer a non-inducing sedative where possible.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Secobarbital and Tacrolimus, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Secobarbital
- Calcium / magnesium / potassium / sodium oxybates + Secobarbital Contraindicated
- Doravirine + Secobarbital Contraindicated
- Elbasvir / grazoprevir + Secobarbital Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Secobarbital Contraindicated
- Isavuconazonium + Secobarbital Contraindicated
- Lonafarnib + Secobarbital 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 Secobarbital with Tacrolimus?
MediHelp rates the interaction as major. Secobarbital 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. Secobarbital can lower tacrolimus blood concentrations, risking subtherapeutic immunosuppression and graft rejection. The induction develops over days to weeks and fades slowly after the barbiturate is stopped.
How serious is the interaction between Secobarbital 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: Measure tacrolimus trough levels frequently when starting or stopping secobarbital and adjust the dose accordingly. Prefer a non-inducing sedative where possible.
What other medicines interact with Secobarbital?
MediHelp also lists interactions of Secobarbital with, for example, Calcium / magnesium / potassium / sodium oxybates, Doravirine, Elbasvir / grazoprevir. The full list is on the Secobarbital page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
