Editing Tacrolimus (section)

== Interactions ==

Also like cyclosporin, it has a wide range of interactions. Tacrolimus is primarily metabolised by the [[cytochrome P450]] system of liver enzymes, and there are many substances that interact with this system and induce or inhibit the system's metabolic activity.<ref name="AC">{{cite book|title=Austria-Codex|editor=Haberfeld, H|at=Prograf|publisher=Österreichischer Apothekerverlag|location=Vienna|year=2015|language=de}}</ref>

Interactions include that with [[grapefruit]] which increases tacrolimus plasma concentrations. As infections are a major cause of morbidity and mortality in the post-transplant patient, the most commonly{{citation needed|date=October 2016}} reported interactions include interactions with anti-microbial drugs. Macrolide antibiotics including [[erythromycin]] and [[clarithromycin]], as well as several of the newer classes of antifungals, especially of the azole class ([[fluconazole]], [[voriconazole]]), increase tacrolimus levels by competing for cytochrome enzymes.<ref name="AC" />