Drug interactions
Tacrolimus + Tenofovir disoproxil
Severity: Moderate
Tacrolimus and Tenofovir disoproxil: 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
Both drugs can injure the kidney, and together they may increase the risk of acute or chronic renal impairment. Tacrolimus causes afferent arteriolar vasoconstriction, while tenofovir causes proximal tubular toxicity.
What this interaction means in plain words
Tacrolimus and Tenofovir disoproxil 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.
Why it happens
Additive nephrotoxicity through different renal mechanisms (calcineurin-inhibitor vasoconstriction and tenofovir tubular injury).
What to do
Monitor serum creatinine, eGFR, phosphate and tacrolimus trough levels regularly. Consider tenofovir alafenamide or another agent if renal function declines.
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
Frequently asked questions
Can I take Tacrolimus with Tenofovir disoproxil?
MediHelp rates the interaction as moderate. Tacrolimus and Tenofovir disoproxil 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. Both drugs can injure the kidney, and together they may increase the risk of acute or chronic renal impairment. Tacrolimus causes afferent arteriolar vasoconstriction, while tenofovir causes proximal tubular toxicity.
How serious is the interaction between Tacrolimus and Tenofovir disoproxil?
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 serum creatinine, eGFR, phosphate and tacrolimus trough levels regularly. Consider tenofovir alafenamide or another agent if renal function declines.
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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