Drug interactions
Tacrolimus + Tocilizumab
Severity: Major
Tacrolimus and Tocilizumab: 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
Both agents suppress immunity, so combined use raises the risk of serious infection. Tocilizumab may also reduce tacrolimus concentrations by reversing IL-6 mediated suppression of CYP3A4.
What this interaction means in plain words
Tacrolimus and Tocilizumab 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; Tocilizumab belongs to Musculoskeletal.
Why it happens
Additive immunosuppression, plus IL-6 blockade restoring CYP3A4 activity and lowering tacrolimus exposure.
What to do
Monitor tacrolimus trough levels and adjust the dose when tocilizumab is started or stopped. Watch for infection and avoid the combination unless the benefit is clear.
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 Tocilizumab
- Bcg vaccine live + Tocilizumab Contraindicated
- Measles mumps and rubella vaccine live + Tocilizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Tocilizumab Contraindicated
- Measles vaccine + Tocilizumab Contraindicated
- Rubella vaccine + Tocilizumab Contraindicated
- Smallpox vaccine live + Tocilizumab 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 Tacrolimus with Tocilizumab?
MediHelp rates the interaction as major. Tacrolimus and Tocilizumab 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. Both agents suppress immunity, so combined use raises the risk of serious infection. Tocilizumab may also reduce tacrolimus concentrations by reversing IL-6 mediated suppression of CYP3A4.
How serious is the interaction between Tacrolimus and Tocilizumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor tacrolimus trough levels and adjust the dose when tocilizumab is started or stopped. Watch for infection and avoid the combination unless the benefit is clear.
What other medicines interact with Tocilizumab?
MediHelp also lists interactions of Tocilizumab with, for example, Bcg vaccine live, Measles mumps and rubella vaccine live, Measles mumps rubella and varicella vaccine live. The full list is on the Tocilizumab page.
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