Tacrolimus Interactions
What is Tacrolimus?
Tacrolimus (sold under the brand names: Astagraf XL, Envarsus XR, Prograf) is mainly used to prevent kidney transplant rejection (the process in which a transplanted organ is attacked by the patient's own immune system). As a result of this function, tacrolimus is classified through a class of medications called immunosuppressants which works by decreasing the activity of the immune system, preventing a possible attack on the transplanted organ.
How does food interact with Tacrolimus?
Tacrolimus can be characterized as having a narrow therapeutic window, meaning that it has a range of dosages that allow it to provide safe and effective therapy with minimal adverse effects. As a result, food, drinks, and dietary supplements can have an impact on the effectiveness of the drug. Because of this, it is important for patients taking tacrolimus to reduce their intake of many of the foods outlined below.
Foods to Limit | Reasons |
Grapefruit Pomelo Clementine Pomegranate Ginger Turmeric |
These foods act as CYP3A4 inhibitors (an enzyme in the small intestine that metabolizes many drugs). As a result, when one takes these foods while using tacrolimus, it can stay in the body longer than usual, leading to nephrotoxicity. |
Animal protein Bananas Oranges Carrots Whole grain products Peanuts Leafy greens |
These foods, and others, are high in potassium, which should be avoided. Because tacrolimus works to reduce sodium uptake in the body, it can impair the secretion of potassium, resulting in an accumulation of potassium, often leading to hyperkalemia. As a result, those who are taking these drugs should be sure attempt to avoid high potassium foods and limit their daily potassium intake. |
Green Tea Green Tea extracts | In certain studies, green tea has been shown to increase blood tacrolimus levels, increasing the risk side effects. As a result, its recommended to avoid the unnecessary effects that green tea may impose. |
Disclaimer: The UCLA Health System cannot guarantee the accuracy of such information. The information is provided without warranty or guarantee of any kind. Please speak to your Physician before making any changes.
Sources + More Information:
Miłosz Miedziaszczyk, Aleksander Bajon, Ewelina Jakielska, Primke, M., Sikora, J., Dagmara Skowrońska, & Idasiak-Piechocka, I. (2022). Controversial Interactions of Tacrolimus with Dietary Supplements, Herbs and Food. Pharmaceutics, 14(10), 2154–2154. https://doi.org/10.3390/pharmaceutics14102154
Gisella Vischini, Niscola, P., Stefoni, A., & Farneti, F. (2011). Increased Plasma Levels of Tacrolimus After Ingestion of Green Tea. American Journal of Kidney Diseases, 58(2), 329–329. https://doi.org/10.1053/j.ajkd.2011.05.013