Tacrolimus Oral

Tacrolimus Oral Interactions

See also How to Use section.

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medications because very serious interactions may occur:

• ziprasidone
• cyclosporine

If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting tacrolimus.

Other drugs besides tacrolimus and ziprasidone which may affect the heart rhythm (QTc prolongation in the EKG) include amiodarone, dofetilide, pimozide, quinidine, sotalol, procainamide, and clarithromycin, among others. QTc prolongation can infrequently result in serious (rarely fatal) irregular heartbeat. Consult your doctor or pharmacist for more details and for instructions on how you may minimize the risk of this effect.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of:

• cisapride
• drugs affecting liver enzymes that remove tacrolimus from your body (such as azole antifungals including itraconazole, calcium channel blockers including nifedipine, macrolide antibiotics including erythromycin, cimetidine, danazol, bromocriptine, nefazodone, protease inhibitors including nelfinavir, ritonavir, rifamycins including rifampin, rifabutin, St. John's wort, certain anti-seizure medicines including carbamazepine, phenytoin)
• drugs affecting the kidneys (e.g., amphotericin B, cisplatin, ganciclovir, aminoglycosides such as gentamicin)
• drugs that increase your potassium levels (e.g., potassium-sparing diuretics such as spironolactone, potassium supplements, ACE inhibitors such as lisinopril)
• metoclopramide
• sirolimus
• temsirolimus
• proton pump inhibitors including omeprazole

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

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