Interacción de Fluconazol con Tacrolimus
Fluconazol con Tacrolimus: ambas etiquetas de prescripción advierten sobre esta combinación con el lenguaje más contundente, como una contraindicación, una advertencia en recuadro o la indicación de evitarla.
No combinar sin la orientación de un prescriptor. El lenguaje de la etiqueta que aparece a continuación es el más contundente que usa la FDA.
Qué dicen las etiquetas de la FDA
De la etiqueta de Fluconazol (Fluconazole) · vigente desde 2026-04-02
Coadministration of other drugs known to prolong the QT interval and which are metabolized via the enzyme CYP3A4 such as erythromycin, pimozide, and quinidine are contraindicated in patients receiving fluconazole.
Tacrolimus Fluconazole may increase the serum concentrations of orally administered tacrolimus up to 5 times due to inhibition of tacrolimus metabolism through CYP3A4 in the intestines.
Increased tacrolimus levels have been associated with nephrotoxicity.
Dosage of orally administered tacrolimus should be decreased depending on tacrolimus concentration.
No significant pharmacokinetic changes have been observed when tacrolimus is given intravenously.
De la etiqueta de Tacrolimus (ASTAGRAF XL) · vigente desde 2026-01-14
The risk for nephrotoxicity may increase when ASTAGRAF XL is concomitantly administered with CYP3A inhibitors (by increasing tacrolimus whole blood concentrations) or drugs associated with nephrotoxicity (e.g., aminoglycosides, ganciclovir, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors).
Risk of Rejection with Strong CYP3A Inducers and Risk of Serious Adverse Reactions with Strong CYP3A Inhibitors The concomitant use of strong CYP3A inducers may increase the metabolism of tacrolimus, leading to lower whole blood trough concentrations and greater risk of rejection.
In contrast, the concomitant use of strong CYP3A inhibitors may decrease the metabolism of tacrolimus, leading to higher whole blood trough concentrations and greater risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see Warnings and Precautions ( 5.7 , 5.11 )] .
Therefore, adjust ASTAGRAF XL dose and monitor tacrolimus whole blood trough concentrations when co-administering ASTAGRAF XL with strong CYP3A inhibitors (e.g., including, but not limited to, telaprevir, boceprevir, ritonavir, ketoconazole, itraconazole, voriconazole, clarithromycin) or strong CYP3A inducers (e.g., including, but not limited to, rifampin, rifabutin)…
A rapid, sharp rise in tacrolimus levels has been reported after co-administration with a strong CYP3A4 inhibitor, clarithromycin, despite an initial reduction of tacrolimus dose.
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Abrir en el verificadorNo es un consejo médico. Interaction Checker cita el texto de las etiquetas de la FDA y las hojas informativas de los NIH. Que una interacción sea importante en su caso depende de las dosis, el momento de las tomas, la función renal y hepática y otras afecciones. Confírmelo con un farmacéutico o un prescriptor.