ibu and Fk506 Interactions

Interactions between ibu(ibuprofen) and Fk506 (tacrolimus)

ibuprofen and tacrolimus (Major Drug-Drug)

MONITOR CLOSELY: Coadministration of macrolide immunosuppressants with other nephrotoxic agents may increase the risk and severity of renal impairment due to additive effects on the kidney. No formal interaction studies have been performed. However, clinical experience in coadministration with cyclosporine indicates increased renal toxicity as evidenced by increased serum creatinine and decreased glomerular filtration rate. An interaction with ibuprofen resulting in acute renal failure was suspected in two liver transplant patients who had been stabilized on tacrolimus.

MANAGEMENT: Caution is advised if macrolide immunosuppressants must be used in patients who have recently received or are receiving treatment with other potentially nephrotoxic drugs (e.g., aminoglycosides, polypeptide and polymyxin antibiotics, vancomycin, amphotericin B, adefovir, cidofovir, tenofovir, foscarnet, cisplatin, cyclosporine, gallium nitrate, lithium, mesalamine, intravenous bisphosphonates, intravenous pentamidine, high intravenous dosages of methotrexate, high dosages of nonsteroidal anti-inflammatory agents). Renal function should be closely monitored both during and after discontinuation of therapy.