What the FDA labels say about taking them together
Fluconazole and tacrolimus
Fluconazole's FDA label (Fluconazole) of April 2, 2026 names tacrolimus in its drug interactions section, and tacrolimus's label names fluconazole too. The tacrolimus label: “Monitor tacrolimus whole blood trough concentrations and reduce ENVARSUS XR dose if needed.”
Check it at the source: the fluconazole FDA label on DailyMed (effective April 7, 2026, Zydus Pharmaceuticals (USA) Inc.); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the fluconazole label say about tacrolimus?
Fluconazole label (Mylan Pharmaceuticals Inc., April 2, 2026), drug interactionsTacrolimus Fluconazole may increase the serum concentrations of orally administered tacrolimus up to 5 times due to inhibition of tacrolimus metabolism through CYP3A4 in the intestines.
Source: FDA drug label (Fluconazole, NDA020090), Mylan Pharmaceuticals Inc., effective April 2, 2026 (SPL set 737e0fac-a2d2-4053-a0d7-edbfb6248f69), via openFDA
Source: FDA drug label (fluconazole), Zydus Pharmaceuticals (USA) Inc., effective April 7, 2026 (SPL set d1364455-1537-46d4-b093-38cca3be778f), via openFDA; the full label on DailyMed
What does the tacrolimus label say about fluconazole?
Tacrolimus label, drug interactionsDrug/Substance Class or Name: Mild or Moderate CYP3A Inhibitors: Clotrimazole, antibiotics (e.g., erythromycin, fluconazole), calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, nicardipine), amiodarone, danazol, ethinyl estradiol, cimetidine, lansoprazole and omeprazole; Drug Interaction Effect: May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see,,)].; Recommendations: Monitor tacrolimus whole blood trough concentrations and reduce tacrolimus dose if needed [ see,) and ].
Envarsus Xr label (Veloxis Pharmaceuticals, Inc, February 26, 2025), drug interactionsDrug/Substance Class or Name: Mild or Moderate CYP3A Inhibitors, such as: antibiotics (e.g., erythromycin), calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, nicardipine), amiodarone, danazol, ethinyl estradiol, cimetidine, lansoprazole and omeprazole, azole antifungals (e.g., clotrimazole, fluconazole, isavuconazole), imatinib, nilotinib, letermovir; Drug Interaction Effect: May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see,, ].; Recommendations: Monitor tacrolimus whole blood trough concentrations and reduce ENVARSUS XR dose if needed [see and ].
Source: FDA drug label (Envarsus Xr, NDA206406), Veloxis Pharmaceuticals, Inc, effective February 26, 2025 (SPL set de2315b0-6344-43ac-9aea-3e3b68d828e7), via openFDA
Source: FDA drug label (Tacrolimus), Stellon Biotech Inc., effective July 17, 2026 (SPL set 6b89e8a4-9f11-42e3-8e79-fe617e7c461f), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Fluconazole | Tacrolimus | |
|---|---|---|
| Labeled for | Fungal infections, Urinary tract infections | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.380 per tablet 200 mg tablet | $0.970 per gram 0.1% ointment |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once