Does Tacrolimus Interact with Midazolam?
CDI records a moderate classification for Tacrolimus and Midazolam. The stored summary is: Effects of Other Drugs/Substances on ENVARSUS XR a, d a ENVARSUS XR dosage adjustment recommendation based on observed effect of co-administered drug on tacrolimus exposures [see Clinical Pharmacology (12.3) ] , literature reports of altered tacrolimus exposures, or the other drug’s known CYP3A inhibitor/inducer status b High dose or double strength grapefruit juice is a strong CYP3A inhibitor; low dose or single strength grapefruit juice is a moderate CYP3A inhibitor c Strong CYP3A inhibitor/inducer, based on reported effect on exposures to immediate-release tacrolimus along with supporting in vitro CYP3A inhibitor/inducer data, or based on drug-drug interaction studies with midazolam (sensitive CYP3A probe substrate) d A drug interaction study with voriconazole was conducted for ENVARSUS XR [see Clinical Pharmacology (12.3) ] . Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This record was extracted from drug labeling through openFDA. NIH/NLM RxNorm is used for drug identities. The summary and severity classification are CDI's processed information, not a verbatim source quotation. Product, route, and patient circumstances matter.
Evidence status
A current label comparison is not yet available for this record. The summary and severity are stored CDI information; they have not been independently validated on this page against the exact product label.
Confirm the medicine, formulation, route, and applicable warning with your pharmacist or prescriber. Independent clinical review has not been recorded.
- Stored CDI classification
- Moderate
- Tacrolimus Class
- Calcineurin Inhibitor Immunosuppressant
- Midazolam Class
- Benzodiazepine
- Management
- Confirm exact products with your pharmacist
- Data Source
- U.S. FDA via OpenFDA
What To Tell Your Doctor or Pharmacist
If you are taking Tacrolimus and your doctor is considering prescribing Midazolam (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider