Medications that can affect Tacrolimus or Cyclosporine

Tacrolimus (TAC) is an immunosuppression medicine that prevents rejection. Tacrolimus has many nicknames such as Tac, Tacro, Prograf®, FK, and FK506.

Cyclosporine (CsA) is an immunosuppression medicine that prevents rejection. It has nicknames based on brand such as Gengraf®, Neoral®, or Sandimmune®. It is important to stick to the same brand unless indicated by your transplant team.

Please note: this list is NOT comprehensive, and it is important to always discuss with your transplant team prior to starting something new including herbals, vitamins and over the counter medications.

Medications/Drugs That Decrease TAC or CsA Level

• Bosentan
• Carbamazepine
• Cinacalcet
• Efavirenz
• Etravirine
• Nevirapine
• Orlistat
• Phenobarbital
• Phenytoin
• Primodone
• Rifabutin
• Rifampin

Medications/Drugs That Increase TAC or CsA Level

• Allopurinol (CSA only)
• Amiodarone
• Amlodipine (TAC only)
• Aprepitant
• Atazanavir
• Carvedilol
• Chloramphenicol
• Cimetidine
• Clarithromycin
• Cobicistat
• Darunavir
• Delavirdine
• Desipramine
• Diltiazem
• Dipyridamole
• Erythromycin
• Estrogen preparations (CSA only)
• Felodipine (TAC only)
• Fluconazole
• Fluoxetine
• Fluvoxamine
• Fosamprenavir
• Fosaprepitant
• Glyburide
• Haloperidol
• Indinavir
• Itraconazole
• Ketoconazole (oral)
• Lansoprazole (TAC only)
• Levofloxacin
• Lopinavir-ritronavir
• Metoclopramide
• Metronidazole
• Nelfinavir
• Nifedipine (TAC only)
• Nimodipine (TAC only)
• Norfloxacin (CSA only)
• Omeprazole (TAC only)
• Posaconazole
• Propranolol
• Quinidine
• Quinine
• Ritonavir
• Saquinavir
• Sertraline
• Testosterone preparation
• Tetracycline
• Tipravir
• Trazodone
• Verapamil
• Voriconazole

This information should not replace medical advice from your doctors or medical team. We encourage our readers to follow their transplant team's medical advice and reach out to their doctors and medical team for further recommendations.