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Drug Interactions between caspofungin and tacrolimus

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

tacrolimus caspofungin

Applies to: tacrolimus and caspofungin

MONITOR: Caspofungin may reduce the plasma concentrations of tacrolimus. In healthy subjects, the area under the concentration-time curve (AUC) of tacrolimus was decreased by approximately 20%, peak blood concentration (Cmax) by 16%, and 12-hour blood concentration by 26% when tacrolimus (0.1 mg/kg twice a day) was administered during the tenth day of caspofungin therapy (70 mg/day), as compared to results from a control period in which tacrolimus was administered alone. The mechanism of this potential interaction is unknown. In vitro studies indicate that caspofungin is not an inhibitor of any enzyme in the CYP450 system.

MANAGEMENT: During concomitant therapy, tacrolimus blood levels should be monitored as usual and the dosage adjusted accordingly, particularly following initiation or discontinuation of caspofungin therapy in patients who are stabilized on tacrolimus.

References

  1. (2001) "Product Information. Cancidas (caspofungin)." Merck & Co., Inc

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Drug and food interactions

Moderate

tacrolimus food

Applies to: tacrolimus

ADJUST DOSING INTERVAL: Consumption of food has led to a 27% decrease in the bioavailability of orally administered tacrolimus.

MANAGEMENT: Tacrolimus should be administered at least one hour before or two hours after meals.

GENERALLY AVOID: Grapefruit juice has been reported to increase tacrolimus trough concentrations. Data are limited, but inhibition of the CYP450 enzyme system appears to be involved.

MANAGEMENT: The clinician may want to recommend that the patient avoid ingesting large amounts of grapefruit juice while taking tacrolimus.

References

  1. (2001) "Product Information. Prograf (tacrolimus)." Fujisawa
  2. Hooks MA (1994) "Tacrolimus, a new immunosuppressant--a review of the literature." Ann Pharmacother, 28, p. 501-11

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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