Drug interactions
Tacrolimus + Topotecan
Severity: Moderate
Tacrolimus and Topotecan: 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
Tacrolimus is a P-glycoprotein inhibitor and may increase topotecan exposure, mainly relevant to oral topotecan. Higher levels may worsen myelosuppression, and both drugs can independently cause hematologic toxicity.
What this interaction means in plain words
Tacrolimus and Topotecan 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.
Tacrolimus belongs to Miscellaneous; Topotecan belongs to Oncology.
Why it happens
P-glycoprotein inhibition by tacrolimus reduces topotecan efflux.
What to do
Avoid combining with oral topotecan. With IV topotecan, monitor complete blood counts closely and adjust the dose for neutropenia.
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 Topotecan
- Adenovirus types 4 and 7 live + Topotecan Contraindicated
- Amiodarone + Topotecan Major
- Cisplatin + Topotecan Major
- Cobicistat + Topotecan Major
- Cyclosporine + Topotecan Major
- Cyclosporin + Topotecan Major
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 Topotecan?
MediHelp rates the interaction as moderate. Tacrolimus and Topotecan 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. Tacrolimus is a P-glycoprotein inhibitor and may increase topotecan exposure, mainly relevant to oral topotecan. Higher levels may worsen myelosuppression, and both drugs can independently cause hematologic toxicity.
How serious is the interaction between Tacrolimus and Topotecan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining with oral topotecan. With IV topotecan, monitor complete blood counts closely and adjust the dose for neutropenia.
What other medicines interact with Topotecan?
MediHelp also lists interactions of Topotecan with, for example, Adenovirus types 4 and 7 live, Amiodarone, Cisplatin. The full list is on the Topotecan page.
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