Exakte Wirkstoffkennungen und zitierbare Passagen zu Wechselwirkungen, Gegenanzeigen und Nebenwirkungen.
Ein Paarvergleich findet Originalpassagen, die den anderen Wirkstoff wörtlich nennen. Aussagen gelten für das jeweilige Präparat und seine Formulierung. Klassenbegriffe und abweichende Synonyme können fehlen. Kein Treffer bedeutet nicht, dass keine Wechselwirkung besteht.
11
Drug/Substance Class or Drug interaction effect Recommendations concerning
Name co-administration
In vitro the following May increase tacrolimus whole Monitor tacrolimus whole
substances have been shown blood trough concentrations and blood trough concentrations
to be potential inhibitors of increase the risk of serious adverse and reduce tacrolimus dose if
tacrolimus metabolism: reactions (e.g., neurotoxicity, QT needed [see section 4.2].
bromocriptine, cortisone, prolongation) [see section 4.4]. Monitor renal function, ECG
dapsone, ergotamine, for QT prolongation, and other
gestodene, lidocaine, side effects closely.
mephenytoin, midazolam,
nilvadipine, norethisterone,
quinidine, tamoxifen
Strong CYP3A4 inducers: May decrease tacrolimus whole It is recommended that
rifampicin, phenytoin, blood trough concentrations and concomitant use should be
carbamazepine, apalutamide, increase the risk of rejection [see avoided. If unavoidable,
enzalutamide, mitotane, or section 4.4]. patients may require an
St. John’s wort (Hypericum Maximal effect on tacrolimus blood increase in tacrolimus dose.
perforatum) concentrations may be achieved 1-2 Changes in tacrolimus dose
weeks after co-administration. The should be individualized and
effect may remain 1-2 weeks after adjusted as needed based on
completion of the treatment. tacrolimus trough
concentrations, which should
be assessed at initiation,
monitored frequently
throughout (starting within the
first few days) and re-
evaluated on and after
completion of the CYP3A4
inducer. After use of the
CYP3A4 inducer has ended,
tacrolimus dose may need to
be adjusted gradually. Monitor
graft function closely.
Moderate CYP3A4 inducers: May decrease tacrolimus whole Monitor tacrolimus whole
metamizole, phenobarbital, blood trough concentrations and blood trough concentrations
isoniazid, rifabutin, increase the risk of rejection [see and increase tacrolimus dose if
efavirenz, etravirine, section 4.4]. needed [see section 4.2].
nevirapine; weak CYP3A4 Monitor graft function closely.
inducers: flucloxacillin
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
11
Drug/Substance Class or Drug interaction effect Recommendations concerning co-
Name administration
The effect on tacrolimus
blood concentrations may
remain for several days after
co-administration is
completed.
Moderate or weak CYP3A4 May increase tacrolimus Monitor tacrolimus whole blood
inhibitors: whole blood trough trough concentrations frequently,
antifungal agents (e.g., concentrations and increase starting within the first few days
fluconazole, isavuconazole, the risk of serious adverse of co-administration. Reduce
clotrimazole, miconazole), reactions (e.g., neurotoxicity, tacrolimus dose if needed [see
the macrolide antibiotics QT prolongation) [see section 4.2]. Monitor renal
(e.g., azithromycin), calcium section 4.4]. A rapid increase function, ECG for QT
channel blockers (e.g., in tacrolimus level may prolongation, and other side
nifedipine, nicardipine, occur. effects closely.
diltiazem, verapamil),
amiodarone, danazol,
ethinylestradiol, lansoprazole,
omeprazole, the HCV
antivirals elbasvir/grazoprevir
and glecaprevir/pibrentasvir,
the CMV antiviral letermovir,
and the tyrosine kinase
inhibitors nilotinib, crizotinib
and imatinib and (Chinese)
herbal remedies containing
extracts of Schisandra
sphenanthera
In vitro the following May increase tacrolimus Monitor tacrolimus whole blood
substances have been shown whole blood trough trough concentrations and reduce
to be potential inhibitors of concentrations and increase tacrolimus dose if needed [see
tacrolimus metabolism: the risk of serious adverse section 4.2].
bromocriptine, cortisone, reactions (e.g., neurotoxicity, Monitor renal function, ECG for
dapsone, ergotamine, QT prolongation) [see QT prolongation, and other side
gestodene, lidocaine, section 4.4]. effects closely.
mephenytoin, midazolam,
nilvadipine, norethisterone,
quinidine, tamoxifen
Strong CYP3A4 inducers: May decrease tacrolimus It is recommended that
rifampicin, phenytoin whole blood trough concomitant use should be
carbamazepine, apalutamide, concentrations and increase avoided. If unavoidable, patients
enzalutamide, mitotane or St. the risk of rejection [see may require an increase in
John’s wort (Hypericum section 4.4]. tacrolimus dose. Changes in
perforatum) Maximal effect on tacrolimus tacrolimus dose should be
blood concentrations may be individualized and adjusted as
achieved 1-2 weeks after co- needed based on tacrolimus
administration. The effect trough concentrations, which
may remain 1-2 weeks after should be assessed at initiation,
completion of the treatment. monitored frequently throughout
(starting within the first few days)
and re-evaluated on and after
completion of the CYP3A4
inducer. After use of the CYP3A4
inducer has ended, tacrolimus
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
12
Drug/Substance Class or Drug interaction effect Recommendations concerning
Name co-administration
In vitro the following May increase tacrolimus whole Monitor tacrolimus whole
substances have been shown blood trough concentrations and blood trough concentrations
to be potential inhibitors of increase the risk of serious adverse and reduce tacrolimus dose if
tacrolimus metabolism: reactions (e.g., neurotoxicity, QT needed (see section 4.2).
bromocriptine, cortisone, prolongation) (see section 4.4). Monitor renal function, ECG
dapsone, ergotamine, for QT prolongation, and other
gestodene, lidocaine, side effects closely.
mephenytoin, midazolam,
nilvadipine, norethisterone,
quinidine, tamoxifen.
Strong CYP3A4 inducers: May decrease tacrolimus whole It is recommended that
rifampicin, phenytoin, blood trough concentrations and concomitant use should be
carbamazepine, apalutamide, increase the risk of rejection (see avoided. If unavoidable,
enzalutamide, mitotane, or St. section 4.4). patients may require an
John’s wort (Hypericum Maximal effect on tacrolimus blood increase in tacrolimus dose.
perforatum) concentrations may be achieved 1-2 Changes in tacrolimus dose
weeks after co-administration. The should be individualized and
effect may remain 1-2 weeks after adjusted as needed based on
completion of the treatment. tacrolimus trough
concentrations, which should
be assessed at initiation,
monitored frequently
throughout (starting within the
first few days) and re-
evaluated on and after
completion of the CYP3A4
inducer. After use of the
CYP3A4 inducer has ended,
tacrolimus dose may need to
be adjusted gradually. Monitor
graft function closely.
Moderate CYP3A4 inducers: May decrease tacrolimus whole Monitor tacrolimus whole
metamizole, phenobarbital, blood trough concentrations and blood trough concentrations
isoniazid, rifabutin, efavirenz, increase the risk of rejection (see and increase tacrolimus dose if
etravirine, nevirapine section 4.4). needed (see section 4.2).
Weak CYP3A4 inducers: Monitor graft function closely.
flucloxacillin
Caspofungin May decrease tacrolimus whole Monitor tacrolimus whole
blood trough concentrations and blood trough concentrations
increase the risk of rejection. and increase tacrolimus dose if
Mechanism of interaction has not needed (see section 4.2).
been confirmed. Monitor graft function closely.
Cannabidiol (P-gp inhibitor) There have been reports of Tacrolimus and cannabidiol
increased tacrolimus blood levels should be co-administered with
during concomitant use of caution, closely monitoring for
tacrolimus with cannabidiol. This side effects. Monitor
may be due to inhibition of tacrolimus whole blood trough
intestinal P-glycoprotein, leading to concentrations and adjust the
increased bioavailability of tacrolimus dose if needed (see
tacrolimus. sections 4.2 and 4.4).
Originalpassage; keine automatisch abgeleitete Schwere, Häufigkeit oder Kausalität. Auch verneinte Befunde und nicht untersuchte Kombinationen bleiben sichtbar.
Version 2025-05-08T17:10:00Z · SHA-256 bf71e479a3104e9d8dd9aede574f2baf87c2d76cd8cc9266ee2ef92ed475dc55 · Passage fa1f35020c5c33f04f1dedfbde5310972baf1c60d65f0f37f47f320487c85aab · Zeichen 8700–13685 im Abschnitt
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