Erythromycin and Tacrolimus: Drug Interaction Guide

Quick answer: This is a major interaction — avoid combining Erythromycin and Tacrolimus unless specifically directed by your doctor.

Interaction severity: Major — avoid combination

How Erythromycin interacts with Tacrolimus

Erythromycin inhibits CYP3A4 and P-glycoprotein, significantly increasing tacrolimus blood concentrations and risk of nephrotoxicity and neurotoxicity.

What you should do

Avoid combination where possible; if required, reduce tacrolimus dose by 50% and check trough level within 2-3 days.

Key facts

Severity

Major — avoid combination

Mechanism

Erythromycin inhibits CYP3A4 and P-glycoprotein, significantly increasing tacrolimus blood concentrations and risk of ne...

Action

Avoid combination where possible; if required, reduce tacrolimus dose by 50% and check trough level within 2-3 days.

Important medical disclaimer: This page provides educational information about drug interactions for general reference. It is not a substitute for professional medical advice, diagnosis, or treatment. Always discuss your specific medications with a qualified healthcare provider before starting, stopping, or changing any treatment. About our editorial team.

Frequently asked questions

Can I take Erythromycin and Tacrolimus together?

No — this combination should generally be avoided. Avoid combination where possible; if required, reduce tacrolimus dose by 50% and check trough level within 2-3 days.

What is the severity of this interaction?

The interaction between Erythromycin and Tacrolimus is classified as Major — avoid combination. Erythromycin inhibits CYP3A4 and P-glycoprotein, significantly increasing tacrolimus blood concentrations and risk of nephrotoxicity and neurotoxicity.

What should I do if I'm prescribed both?

Avoid combination where possible; if required, reduce tacrolimus dose by 50% and check trough level within 2-3 days. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

Last reviewed: by iMedic Medical Editorial Team. Our editorial process.