MajorAntituberculous antibiotic×Calcineurin inhibitor (immunosuppressant)
Updated · Methodology
Mechanism
Strong CYP3A4 inducer. Tacrolimus falls 3-fold – transplant rejection risk.
Symptoms
Rejection signs, rising creatinine.
Management
For TB in transplant patient – increase tacrolimus 3-5 fold with blood level monitoring. Alternative – rifabutin (weaker).
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
- FDA: Rifampin capsule (Ani Pharmaceuticals, Inc.) – Prescribing Information (2010)– ; DailyMed setid b389b1a3-672f-47e3-916c-4a9c044b211b
- FDA: Prograf (tacrolimus) prescribing information – CYP3A4 inducer interactions (2021)– FDA Prograf label, Drug Interactions §7; DailyMed setid 7f667de1-9dfa-4bd6-8ba0-15ee2d78873b
- 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