Drug interactions
Tacrolimus + Ustekinumab
Severity: Major
Tacrolimus and Ustekinumab: 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
Combining a biologic that blocks IL-12/23 with a calcineurin inhibitor can intensify immunosuppression and increase the risk of serious and opportunistic infections. Data in transplant or other tacrolimus-treated patients are limited.
What this interaction means in plain words
Tacrolimus and Ustekinumab 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; Ustekinumab belongs to Gastrointestinal Tract.
Why it happens
Additive immunosuppression through IL-12/23 blockade and calcineurin inhibition of T-cell activation.
What to do
Avoid the combination if alternatives exist; if it is necessary, screen for latent tuberculosis, monitor closely for infection, and keep tacrolimus trough levels within target.
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 Ustekinumab
- Bcg vaccine live + Ustekinumab Contraindicated
- Typhoid vaccine live + Ustekinumab Contraindicated
- Adalimumab + Ustekinumab Major
- Adenovirus types 4 and 7 live + Ustekinumab Major
- Alefacept + Ustekinumab Major
- Anakinra + Ustekinumab 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 Ustekinumab?
MediHelp rates the interaction as major. Tacrolimus and Ustekinumab 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. Combining a biologic that blocks IL-12/23 with a calcineurin inhibitor can intensify immunosuppression and increase the risk of serious and opportunistic infections. Data in transplant or other tacrolimus-treated patients are limited.
How serious is the interaction between Tacrolimus and Ustekinumab?
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 alternatives exist; if it is necessary, screen for latent tuberculosis, monitor closely for infection, and keep tacrolimus trough levels within target.
What other medicines interact with Ustekinumab?
MediHelp also lists interactions of Ustekinumab with, for example, Bcg vaccine live, Typhoid vaccine live, Adalimumab. The full list is on the Ustekinumab page.
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