A patient is given tacrolimus, which antibiotic should not be given to him?
Tacrolimus is a calcineurin inhibitor which is a specific T cell inhibitor is a very potent immunosuppressant drug. It is administered orally and by i.v infusion it is metabolized by CYP3A4 and excreted in bile. Among the given drugs Rifampicin is an enzyme inducer -increases several CYP450 isoenzymes like CYP3A4, CYP2D6, CYP1A2, CYP2C subfamily. Hence it increases the metabolism of several drugs like warfarin, tacrolimus, oral contraceptives, coicosteroids , sulfonylureas, ketakonazole,fluconazole,phenytoin,etc.so rifampicin is avoided. ESSENTIAL of MEDICAL pHARMACOLOGY. SEVENTH EDITION -KD TRIPATHI Page no:768,885
Gentamicin
Ciplatin
Rifampicin
Vancomycin
Immunomodulators