Drug interactions
Tacrolimus + Vancomycin
Severity: Moderate
Tacrolimus and Vancomycin: 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 causes dose-dependent renal vasoconstriction and nephrotoxicity, and vancomycin adds to the risk of acute kidney injury. Transplant patients are particularly vulnerable because renal injury can compromise graft function.
What this interaction means in plain words
Tacrolimus and Vancomycin 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; Vancomycin belongs to Anti Bacterial.
Why it happens
Additive nephrotoxicity via afferent arteriolar vasoconstriction (tacrolimus) and tubular injury (vancomycin).
What to do
Monitor serum creatinine, tacrolimus trough and vancomycin levels closely. Adjust doses promptly if renal function worsens.
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 Vancomycin
- Amikacin + Vancomycin Major
- Bacitracin + Vancomycin Major
- Capreomycin + Vancomycin Major
- Cephaloridine + Vancomycin Major
- Cidofovir + Vancomycin Major
- Cisplatin + Vancomycin 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 Vancomycin?
MediHelp rates the interaction as moderate. Tacrolimus and Vancomycin 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 causes dose-dependent renal vasoconstriction and nephrotoxicity, and vancomycin adds to the risk of acute kidney injury. Transplant patients are particularly vulnerable because renal injury can compromise graft function.
How serious is the interaction between Tacrolimus and Vancomycin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine, tacrolimus trough and vancomycin levels closely. Adjust doses promptly if renal function worsens.
What other medicines interact with Vancomycin?
MediHelp also lists interactions of Vancomycin with, for example, Amikacin, Bacitracin, Capreomycin. The full list is on the Vancomycin page.
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