Drug interactions
Tacrolimus + Vincristine
Severity: Moderate
Tacrolimus and Vincristine: 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 is a P-glycoprotein substrate and inhibitor and a CYP3A4 substrate, so it may compete with vincristine for efflux and metabolism. This could increase vincristine exposure and neurotoxicity, and both drugs have neurotoxic potential.
What this interaction means in plain words
Tacrolimus and Vincristine 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; Vincristine belongs to Oncology.
Why it happens
Tacrolimus competitively inhibits P-glycoprotein and CYP3A4 handling of vincristine, and the two drugs have additive neurotoxicity.
What to do
Monitor for neuropathy, constipation and ileus, and reduce the vincristine dose if toxicity appears. Monitor tacrolimus trough levels as clinically indicated.
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 Vincristine
- Adenovirus types 4 and 7 live + Vincristine Contraindicated
- Apalutamide + Vincristine Major
- Atazanavir + Vincristine Major
- Ceritinib + Vincristine Major
- Chloramphenicol + Vincristine Major
- Clarithromycin + Vincristine 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 Vincristine?
MediHelp rates the interaction as moderate. Tacrolimus and Vincristine 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 is a P-glycoprotein substrate and inhibitor and a CYP3A4 substrate, so it may compete with vincristine for efflux and metabolism. This could increase vincristine exposure and neurotoxicity, and both drugs have neurotoxic potential.
How serious is the interaction between Tacrolimus and Vincristine?
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 for neuropathy, constipation and ileus, and reduce the vincristine dose if toxicity appears. Monitor tacrolimus trough levels as clinically indicated.
What other medicines interact with Vincristine?
MediHelp also lists interactions of Vincristine with, for example, Adenovirus types 4 and 7 live, Apalutamide, Atazanavir. The full list is on the Vincristine page.
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