Drug interactions
Tacrolimus + Venetoclax
Severity: Major
Tacrolimus and Venetoclax: 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
Tacrolimus is a P-gp inhibitor and may raise venetoclax exposure, increasing the risk of myelosuppression and tumor lysis syndrome. Venetoclax may in turn inhibit intestinal P-gp and raise tacrolimus levels, which has a narrow therapeutic index.
What this interaction means in plain words
Tacrolimus and Venetoclax 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; Venetoclax belongs to Miscellaneous.
Why it happens
Mutual inhibition of P-glycoprotein efflux transport affecting absorption and clearance of both drugs.
What to do
Monitor tacrolimus trough levels and renal function and reduce the tacrolimus dose as needed. Consider reducing the venetoclax dose per labeling for P-gp inhibitors and monitor for neutropenia and tumor lysis.
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 Venetoclax
- Clarithromycin + Venetoclax Contraindicated
- Itraconazole + Venetoclax Contraindicated
- Ketoconazole + Venetoclax Contraindicated
- Posaconazole + Venetoclax Contraindicated
- Venetoclax + Voriconazole Contraindicated
- Amiodarone + Venetoclax Major
Frequently asked questions
Can I take Tacrolimus with Venetoclax?
MediHelp rates the interaction as major. Tacrolimus and Venetoclax 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 is a P-gp inhibitor and may raise venetoclax exposure, increasing the risk of myelosuppression and tumor lysis syndrome. Venetoclax may in turn inhibit intestinal P-gp and raise tacrolimus levels, which has a narrow therapeutic index.
How serious is the interaction between Tacrolimus and Venetoclax?
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 renal function and reduce the tacrolimus dose as needed. Consider reducing the venetoclax dose per labeling for P-gp inhibitors and monitor for neutropenia and tumor lysis.
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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