What the FDA labels say about taking them together
Ganciclovir and tacrolimus
Ganciclovir's FDA label of January 9, 2026 names tacrolimus in its drug interactions section, and tacrolimus's label names ganciclovir too. The ganciclovir label: “Because of potential for higher toxicity, coadministration with Ganciclovir should be considered only if the potential benefits are judged to outweigh the risks.”
Check it at the source: the ganciclovir FDA label on DailyMed (effective January 9, 2026, Fresenius Kabi USA, LLC); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the ganciclovir label say about tacrolimus?
Ganciclovir label, drug interactionsName of the Concomitant Drug: Other drugs associated with myelosuppression or nephrotoxicity (e.g., dapsone, doxorubicin, flucytosine, hydroxyurea, pentamidine, tacrolimus, trimethoprim/sulfamethoxazole, vinblastine, vincristine and zidovudine); Change in the Concentration of Ganciclovir or Concomitant Drug: Unknown; Clinical Comment: Because of potential for higher toxicity, coadministration with Ganciclovir should be considered only if the potential benefits are judged to outweigh the risks.
Source: FDA drug label (Ganciclovir), Fresenius Kabi USA, LLC, effective January 9, 2026 (SPL set 35addab5-09db-4f8a-9c69-6fbce33ecc37), via openFDA; the full label on DailyMed
What does the tacrolimus label say about ganciclovir?
Tacrolimus label, warnings and precautionsThe risk for nephrotoxicity may increase when tacrolimus is concomitantly administered with CYP3A inhibitors (by increasing tacrolimus whole blood concentrations) or drugs associated with nephrotoxicity (e.g., aminoglycosides, ganciclovir, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors).
Astagraf Xl label (Astellas Pharma US, Inc., January 14, 2026), warnings and precautionsThe risk for nephrotoxicity may increase when ASTAGRAF XL is concomitantly administered with CYP3A inhibitors (by increasing tacrolimus whole blood concentrations) or drugs associated with nephrotoxicity (e.g., aminoglycosides, ganciclovir, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors).
Source: FDA drug label (Prograf, NDA050708), Astellas Pharma US, Inc., effective August 25, 2023 (SPL set 7f667de1-9dfa-4bd6-8ba0-15ee2d78873b), via openFDA
Source: FDA drug label (Astagraf Xl, NDA204096), Astellas Pharma US, Inc., effective January 14, 2026 (SPL set 550a5cd4-fbf2-4c09-b577-6bde8fcbdf6e), via openFDA
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
| Ganciclovir | Tacrolimus | |
|---|---|---|
| Labeled for | n/a | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $91.24 per gram 0.15% ophthalmic gel | $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