Grapefruit Juice and Tacrolimus: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Grapefruit Juice and Tacrolimus unless specifically directed by your doctor.
How Grapefruit Juice interacts with Tacrolimus
Grapefruit juice inhibits intestinal CYP3A4, increasing tacrolimus bioavailability and trough concentrations with risk of nephrotoxicity and neurotoxicity.
What you should do
Advise transplant patients to avoid grapefruit and Seville oranges; monitor tacrolimus trough levels if inadvertent exposure occurs.
Key facts
Severity
Major — avoid combination
Mechanism
Grapefruit juice inhibits intestinal CYP3A4, increasing tacrolimus bioavailability and trough concentrations with risk o...
Action
Advise transplant patients to avoid grapefruit and Seville oranges; monitor tacrolimus trough levels if inadvertent expo...
Frequently asked questions
Can I take Grapefruit Juice and Tacrolimus together?
No — this combination should generally be avoided. Advise transplant patients to avoid grapefruit and Seville oranges; monitor tacrolimus trough levels if inadvertent exposure occurs.
What is the severity of this interaction?
The interaction between Grapefruit Juice and Tacrolimus is classified as Major — avoid combination. Grapefruit juice inhibits intestinal CYP3A4, increasing tacrolimus bioavailability and trough concentrations with risk of nephrotoxicity and neurotoxicity.
What should I do if I'm prescribed both?
Advise transplant patients to avoid grapefruit and Seville oranges; monitor tacrolimus trough levels if inadvertent exposure occurs. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.