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