Fluconazole and Tacrolimus: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Fluconazole and Tacrolimus unless specifically directed by your doctor.
How Fluconazole interacts with Tacrolimus
Fluconazole inhibits CYP3A4-mediated metabolism of tacrolimus, substantially increasing trough levels and risk of nephrotoxicity and neurotoxicity.
What you should do
Reduce tacrolimus dose by approximately one-third to one-half on initiation of fluconazole and monitor trough levels every 2-3 days until stable.
Key facts
Severity
Major — avoid combination
Mechanism
Fluconazole inhibits CYP3A4-mediated metabolism of tacrolimus, substantially increasing trough levels and risk of nephro...
Action
Reduce tacrolimus dose by approximately one-third to one-half on initiation of fluconazole and monitor trough levels eve...
Frequently asked questions
Can I take Fluconazole and Tacrolimus together?
No — this combination should generally be avoided. Reduce tacrolimus dose by approximately one-third to one-half on initiation of fluconazole and monitor trough levels every 2-3 days until stable.
What is the severity of this interaction?
The interaction between Fluconazole and Tacrolimus is classified as Major — avoid combination. Fluconazole inhibits CYP3A4-mediated metabolism of tacrolimus, substantially increasing trough levels and risk of nephrotoxicity and neurotoxicity.
What should I do if I'm prescribed both?
Reduce tacrolimus dose by approximately one-third to one-half on initiation of fluconazole and monitor trough levels every 2-3 days until stable. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.