Posaconazole and Tacrolimus: Drug Interaction Guide

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

Interaction severity: Major — avoid combination

How Posaconazole interacts with Tacrolimus

Posaconazole strongly inhibits CYP3A4, the main metabolic pathway for tacrolimus. Tacrolimus concentrations can rise markedly, increasing nephrotoxicity, neurotoxicity, and hyperkalemia risk.

What you should do

Reduce tacrolimus dose substantially when starting posaconazole and monitor trough concentrations frequently. Re-adjust after posaconazole is stopped.

Key facts

Severity

Major — avoid combination

Mechanism

Posaconazole strongly inhibits CYP3A4, the main metabolic pathway for tacrolimus. Tacrolimus concentrations can rise mar...

Action

Reduce tacrolimus dose substantially when starting posaconazole and monitor trough concentrations frequently. Re-adjust ...

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 Posaconazole and Tacrolimus together?

No — this combination should generally be avoided. Reduce tacrolimus dose substantially when starting posaconazole and monitor trough concentrations frequently. Re-adjust after posaconazole is stopped.

What is the severity of this interaction?

The interaction between Posaconazole and Tacrolimus is classified as Major — avoid combination. Posaconazole strongly inhibits CYP3A4, the main metabolic pathway for tacrolimus. Tacrolimus concentrations can rise markedly, increasing nephrotoxicity, neurotoxicity, and hyperkalemia risk.

What should I do if I'm prescribed both?

Reduce tacrolimus dose substantially when starting posaconazole and monitor trough concentrations frequently. Re-adjust after posaconazole is stopped. Always consult your prescribing clinician — do not stop or change medications without medical guidance.

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