Drug interactions
Siltuximab + Tacrolimus
Severity: Moderate
Siltuximab 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
Blocking IL-6 with siltuximab can reverse inflammation-driven suppression of CYP450 enzymes. This may increase CYP3A4 activity and lower tacrolimus concentrations, risking subtherapeutic exposure.
What this interaction means in plain words
Siltuximab 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.
Siltuximab belongs to Miscellaneous; Tacrolimus belongs to Miscellaneous.
Why it happens
IL-6 neutralization normalizes suppressed CYP3A4 expression, increasing tacrolimus metabolism.
What to do
Monitor tacrolimus troughs when starting or stopping siltuximab, especially in the weeks after treatment, 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 Siltuximab
- Baricitinib + Siltuximab Major
- Atorvastatin + Siltuximab Moderate
- Carbamazepine + Siltuximab Moderate
- Cyclosporin + Siltuximab Moderate
- Ethinyl estradiol-drospirenone + Siltuximab Moderate
- Ethinyl estradiol-levonorgestrel + Siltuximab Moderate
Frequently asked questions
Can I take Siltuximab with Tacrolimus?
MediHelp rates the interaction as moderate. Siltuximab 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. Blocking IL-6 with siltuximab can reverse inflammation-driven suppression of CYP450 enzymes. This may increase CYP3A4 activity and lower tacrolimus concentrations, risking subtherapeutic exposure.
How serious is the interaction between Siltuximab 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: Monitor tacrolimus troughs when starting or stopping siltuximab, especially in the weeks after treatment, 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.
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