Drug interactions
Tacrolimus + Tipranavir
Severity: Major
Tacrolimus and Tipranavir: 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
Tipranavir is given with ritonavir, which strongly inhibits CYP3A4 and P-glycoprotein, and can greatly raise tacrolimus levels. This risks nephrotoxicity, neurotoxicity and QT prolongation. Tipranavir itself also has some inducing effects, making the net change variable.
What this interaction means in plain words
Tacrolimus and Tipranavir 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.
Tacrolimus belongs to Miscellaneous; Tipranavir belongs to Anti Virals.
Why it happens
Ritonavir-boosted tipranavir inhibits CYP3A4 and P-glycoprotein, reducing tacrolimus clearance.
What to do
Avoid if possible. If necessary, reduce tacrolimus dose or extend the interval and monitor trough levels and renal function frequently.
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?
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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 Tipranavir
- Alfuzosin + Tipranavir Contraindicated
- Amiodarone + Tipranavir Contraindicated
- Atorvastatin + Tipranavir Contraindicated
- Avanafil + Tipranavir Contraindicated
- Cisapride + Tipranavir Contraindicated
- Colchicine + Tipranavir Contraindicated
Frequently asked questions
Can I take Tacrolimus with Tipranavir?
MediHelp rates the interaction as major. Tacrolimus and Tipranavir 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. Tipranavir is given with ritonavir, which strongly inhibits CYP3A4 and P-glycoprotein, and can greatly raise tacrolimus levels. This risks nephrotoxicity, neurotoxicity and QT prolongation. Tipranavir itself also has some inducing effects, making the net change variable.
How serious is the interaction between Tacrolimus and Tipranavir?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if possible. If necessary, reduce tacrolimus dose or extend the interval and monitor trough levels and renal function frequently.
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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