Drug interactions
Tacrolimus + Tisagenlecleucel
Severity: Major
Tacrolimus and Tisagenlecleucel: 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
Tacrolimus is a calcineurin inhibitor that suppresses T-cell activation and may blunt the expansion and persistence of CAR-T cells. This may reduce the efficacy of tisagenlecleucel while adding to the infection risk of profound immunosuppression.
What this interaction means in plain words
Tacrolimus and Tisagenlecleucel 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; Tisagenlecleucel belongs to Oncology.
Why it happens
Pharmacodynamic antagonism, as calcineurin inhibition suppresses T-cell function needed for CAR-T cell expansion and activity.
What to do
Avoid immunosuppressants before and around infusion unless clinically essential, and prefer the shortest possible course. If it is required, monitor for infection and for loss of CAR-T response.
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 Tisagenlecleucel
Frequently asked questions
Can I take Tacrolimus with Tisagenlecleucel?
MediHelp rates the interaction as major. Tacrolimus and Tisagenlecleucel 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 is a calcineurin inhibitor that suppresses T-cell activation and may blunt the expansion and persistence of CAR-T cells. This may reduce the efficacy of tisagenlecleucel while adding to the infection risk of profound immunosuppression.
How serious is the interaction between Tacrolimus and Tisagenlecleucel?
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 immunosuppressants before and around infusion unless clinically essential, and prefer the shortest possible course. If it is required, monitor for infection and for loss of CAR-T response.
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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