Drug interactions
Tacrolimus + Vilanterol / fluticasone furoate inhaled
Severity: Moderate
Tacrolimus and Vilanterol / fluticasone furoate inhaled: 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 may prolong the QT interval, and vilanterol, a long-acting beta-agonist, can add cardiovascular effects. Inhaled systemic exposure is low, so the clinical effect is usually limited, but patients with cardiac risk factors may be affected. Fluticasone furoate is a CYP3A4 substrate, though tacrolimus is not a significant inhibitor.
What this interaction means in plain words
Tacrolimus and Vilanterol / fluticasone furoate inhaled 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.
Why it happens
Additive QT prolongation and beta-adrenergic cardiac effects, with possible beta-agonist-related hypokalemia.
What to do
Monitor ECG and serum potassium and magnesium in patients with cardiac risk factors or other QT-prolonging drugs. Counsel patients to report palpitations or syncope.
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 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 Vilanterol / fluticasone furoate inhaled?
MediHelp rates the interaction as moderate. Tacrolimus and Vilanterol / fluticasone furoate inhaled 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 may prolong the QT interval, and vilanterol, a long-acting beta-agonist, can add cardiovascular effects. Inhaled systemic exposure is low, so the clinical effect is usually limited, but patients with cardiac risk factors may be affected. Fluticasone furoate is a CYP3A4 substrate, though tacrolimus is not a significant inhibitor.
How serious is the interaction between Tacrolimus and Vilanterol / fluticasone furoate inhaled?
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 ECG and serum potassium and magnesium in patients with cardiac risk factors or other QT-prolonging drugs. Counsel patients to report palpitations or syncope.
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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