Tacrolimus and Verapamil: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Tacrolimus and Verapamil unless specifically directed by your doctor.
How Tacrolimus interacts with Verapamil
Verapamil inhibits CYP3A4 and P-glycoprotein, raising tacrolimus trough levels and risking nephrotoxicity, neurotoxicity, and hyperkalaemia.
What you should do
Reduce tacrolimus dose by approximately 50% on initiation and check trough levels within 3-5 days; consider amlodipine as an alternative antihypertensive.
Key facts
Severity
Major — avoid combination
Mechanism
Verapamil inhibits CYP3A4 and P-glycoprotein, raising tacrolimus trough levels and risking nephrotoxicity, neurotoxicity...
Action
Reduce tacrolimus dose by approximately 50% on initiation and check trough levels within 3-5 days; consider amlodipine a...
Frequently asked questions
Can I take Tacrolimus and Verapamil together?
No — this combination should generally be avoided. Reduce tacrolimus dose by approximately 50% on initiation and check trough levels within 3-5 days; consider amlodipine as an alternative antihypertensive.
What is the severity of this interaction?
The interaction between Tacrolimus and Verapamil is classified as Major — avoid combination. Verapamil inhibits CYP3A4 and P-glycoprotein, raising tacrolimus trough levels and risking nephrotoxicity, neurotoxicity, and hyperkalaemia.
What should I do if I'm prescribed both?
Reduce tacrolimus dose by approximately 50% on initiation and check trough levels within 3-5 days; consider amlodipine as an alternative antihypertensive. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.