MajorAntifungal, triazole×Calcineurin inhibitor (immunosuppressant)
Updated · Methodology
Mechanism
Itraconazole is a strong CYP3A4 inhibitor. Tacrolimus rises 5+ fold – severe nephrotoxicity.
Symptoms
Rising creatinine, hypertension, tremor within 3-7 days.
Management
Reduce tacrolimus by 75% with frequent blood level monitoring. If possible, switch itraconazole to an echinocandin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- AEMPS: Ficha tecnica de Prograf (tacrolimus) (2024)– AEMPS CIMA, 2024
- AEMPS: Ficha técnica: Tacrolimus (nº registro 84607), sección 4.4 (2026)– AEMPS, CIMA, nº registro 84607, revisión 03/2026, sección 4.4