Drug interactions
Tacrolimus + Tucatinib
Severity: Major
Tacrolimus and Tucatinib: 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
Tucatinib inhibits CYP3A4 and raises exposure to sensitive CYP3A substrates such as tacrolimus. Elevated tacrolimus levels can cause nephrotoxicity, neurotoxicity, hyperkalemia and hyperglycemia.
What this interaction means in plain words
Tacrolimus and Tucatinib 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; Tucatinib belongs to Oncology.
Why it happens
Inhibition of CYP3A-mediated tacrolimus metabolism by tucatinib.
What to do
Avoid the combination if possible. If it cannot be avoided, reduce the tacrolimus dose and monitor trough levels and renal function closely.
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 Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Tacrolimus with Tucatinib?
MediHelp rates the interaction as major. Tacrolimus and Tucatinib 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. Tucatinib inhibits CYP3A4 and raises exposure to sensitive CYP3A substrates such as tacrolimus. Elevated tacrolimus levels can cause nephrotoxicity, neurotoxicity, hyperkalemia and hyperglycemia.
How serious is the interaction between Tacrolimus and Tucatinib?
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 the combination if possible. If it cannot be avoided, reduce the tacrolimus dose and monitor trough levels and renal function closely.
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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