Tacrolimus(continued)
▶Antifungals, azoles(miconazole)are predicted to increase the
concentration oftacrolimus. Monitor and adjust dose.r
Theoretical
▶Aprepitantis predicted to increase the concentration of
tacrolimus.rStudy
▶Bosentanis predicted to decrease the concentration of
tacrolimusandtacrolimuspotentially increases the
concentration ofbosentan. Avoid.rTheoretical
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the concentration oftacrolimus.rStudy
▶Calcium channel blockers(nicardipine)potentially increase the
concentration oftacrolimus. Monitor concentration and
adjust dose.rAnecdotal
▶Ceritinibis predicted to increase the exposure totacrolimus.
Avoid.rTheoretical
▶Chloramphenicolincreases the concentration oftacrolimus.
rStudy
▶Ciclosporinincreases the concentration oftacrolimus. Avoid.
rStudy→Also seeTABLE 2p. 847→Also seeTABLE 16p. 851
▶Cobicistatis predicted to increase the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶Crizotinibis predicted to increase the concentration of
tacrolimus.rStudy
▶Danazolpotentially increases the concentration oftacrolimus.
rAnecdotal
▶Efavirenzis predicted to decrease the concentration of
tacrolimus. Monitor and adjust dose.oTheoretical
▶Enzalutamidedecreases the concentration oftacrolimus.
Monitor and adjust dose.rStudy
▶Grapefruit juiceincreases the concentration oftacrolimus.
Avoid.rStudy
▶Grazoprevirincreases the exposure totacrolimus.o
Study
▶HIV-protease inhibitorsare predicted to increase the
concentration oftacrolimus. Monitor and adjust dose.r
Study
▶Idelalisibis predicted to increase the concentration of
tacrolimus. Monitor and adjust dose.rStudy
▶Imatinibis predicted to increase the concentration of
tacrolimus.rStudy
▶Live vaccinesare predicted to increase the risk of generalised
infection (possibly life-threatening) when given with
tacrolimus. Public Health England advises avoid (refer to
Green Book).rTheoretical
▶Tacrolimusis predicted to increase the exposure tolomitapide.
Separate administration by 12 hours.oTheoretical
▶Lumacaftoris predicted to decrease the exposure to
tacrolimus. Avoid.rTheoretical
▶Macrolides(clarithromycin)are predicted to increase the
concentration oftacrolimus. Monitor and adjust dose.r
Study
▶Macrolides(erythromycin)are predicted to increase the
concentration oftacrolimus.rStudy
▶Tacrolimusis predicted to affect the efficacy ofmifamurtide.
Avoid.rTheoretical
▶Mitotanedecreases the concentration oftacrolimus. Monitor
and adjust dose.rStudy
▶Monoclonal antibodies(sarilumab)potentially affect the
exposure totacrolimus. Monitor and adjust dose.o
Theoretical
▶Netupitantis predicted to increase the concentration of
tacrolimus.rStudy
▶Nevirapineis predicted to decrease the concentration of
tacrolimus. Monitor and adjust dose.oTheoretical
▶Nilotinibis predicted to increase the concentration of
tacrolimus.rStudy
▶Palbociclibis predicted to increase the exposure totacrolimus.
Adjust dose.oTheoretical
▶Pitolisantis predicted to decrease the exposure totacrolimus.
Avoid.rTheoretical
▶Ranolazineincreases the concentration oftacrolimus. Adjust
dose.rAnecdotal
▶Ribociclibis predicted to increase the exposure totacrolimus.
Use with caution and adjust dose.oTheoretical▶Rifampicindecreases the concentration oftacrolimus. Monitor
and adjust dose.rStudy
▶Sirolimusis predicted to decrease the concentration of
tacrolimusandtacrolimusincreases the exposure tosirolimus.
rStudy
▶St John’s Wortdecreases the concentration oftacrolimus.
Avoid.rStudy
▶Tacrolimusincreases the exposure totofacitinib. Avoid.r
Study
▶Tacrolimuspotentially increases the risk of serotonin
syndrome when given withvenlafaxine.rAnecdotal
Tadalafil→see phosphodiesterase type-5 inhibitors
Tamoxifen→seeTABLE 5p. 847 (thromboembolism)
▶Bupropionis predicted to decrease the efficacy oftamoxifen.
Avoid.rStudy
▶Cinacalcetis predicted to decrease the efficacy oftamoxifen.
Avoid.rStudy
▶Tamoxifenincreases the anticoagulant effect ofcoumarins.
rStudy
▶Rifampicinmarkedly decreases the exposure totamoxifen.
qStudy
▶Rolapitantis predicted to increase the exposure totamoxifen.
rStudy
▶SSRIs(fluoxetine, paroxetine)are predicted to decrease the
efficacy oftamoxifen. Avoid.rStudy
▶Terbinafineis predicted to decrease the efficacy oftamoxifen.
Avoid.rStudy
Tamsulosin→see alpha blockers
Tapentadol→see opioids
Taxanes→seeTABLE 15p. 850 (myelosuppression),TABLE 12p. 850
(peripheral neuropathy)
cabazitaxel.docetaxel.paclitaxel..
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure tocabazitaxel.oTheoretical
▶Antiarrhythmics(dronedarone)are predicted to increase the
exposure topaclitaxel.rTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
todocetaxel.rTheoretical→Also seeTABLE 12p. 850
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
totaxanes(cabazitaxel, paclitaxel). Avoid.rStudy→Also
seeTABLE 12p. 850
▶Antifungals, azoles(fluconazole, isavuconazole, posaconazole)
are predicted to increase the exposure tocabazitaxel.o
Theoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure tocabazitaxel. Avoid.
rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to moderately increase the exposure todocetaxel.
Avoid or adjust dose.rStudy
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to increase the exposure topaclitaxel.r
Theoretical
▶Antifungals, azoles(miconazole)are predicted to increase the
concentration ofdocetaxel. Use with caution and adjust dose.
oTheoretical
▶Aprepitantis predicted to increase the exposure tocabazitaxel.
oTheoretical
▶Bosentanis predicted to decrease the exposure tocabazitaxel.
Avoid.rStudy
▶Calcium channel blockers(diltiazem, verapamil)are predicted to
increase the exposure tocabazitaxel.oTheoretical
▶Ceritinibis predicted to increase the exposure topaclitaxel.
oTheoretical→Also seeTABLE 15p. 850
▶Clopidogrelis predicted to increase the concentration of
paclitaxel.rAnecdotal
▶Cobicistatis predicted to increase the exposure tocabazitaxel.
Avoid.rStudy
▶Cobicistatis predicted to moderately increase the exposure to
docetaxel. Avoid or adjust dose.rStudy
▶Cobicistatis predicted to increase the exposure topaclitaxel.
rTheoretical998 Tacrolimus—Taxanes BNFC 2018 – 2019
Interactions|Appendix 1A1