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What the FDA labels say about taking them together

Tacrolimus and tofacitinib

Tofacitinib's FDA label of July 13, 2026 names tacrolimus in its drug interactions section; the tacrolimus labels PlainMeds reads (4) do not name tofacitinib. The tofacitinib label: “Clinically Significant Interactions Affecting XELJANZ/XELJANZ XR When Concomitantly Used with Other Drugs Strong CYP3A4 Inhibitors (e.g., ketoconazole) Clinical Impact Increased exposure to tofacitinib Intervention …”

Check it at the source: the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.); the tofacitinib FDA label on DailyMed (effective July 13, 2026, U.S. Pharmaceuticals).

What does the tacrolimus label say about tofacitinib?

Tacrolimus's label (effective July 17, 2026) and its 3 other brand-application labels do not name tofacitinib in these sections. A label lists what its studies and reports found; it is not a complete list.

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

What does the tofacitinib label say about tacrolimus?

Tofacitinib label, drug interactions

… to tofacitinib and may result in loss of or reduced clinical response Intervention Concomitant use with XELJANZ/XELJANZ XR is not recommended [see Clinical Pharmacology, Figure 3 (12.3) ] Immunosuppressive Drugs (e.g., azathioprine, tacrolimus, cyclosporine) Clinical Impact Risk of added immunosuppression; concomitant use of XELJANZ/XELJANZ XR with biologic DMARDs or potent immunosuppressants has not been studied in patients with RA, PsA, AS, UC, or pcJIA. Intervention Concomitant use with XELJANZ/XELJANZ XR is not recommended [see Indications and Usage (1), Clinical Pharmacology, Figure 3 (12.3) ] See FPI for clinically significant drug interactions.

Source: FDA drug label (XELJANZ), NDA203214 (Pf Prism Cv), as published by U.S. Pharmaceuticals, effective July 13, 2026 (SPL set 68e3d6b2-7838-4d2d-a417-09d919b43e13), 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

33Tacrolimus generic labelers
24Tofacitinib generic labelers
TacrolimusTofacitinib
Labeled forOrgan transplant rejection, Eczema (atopic dermatitis)Rheumatoid arthritis, Crohn's disease and ulcerative colitis
Boxed warningYesYes
Pharmacy cost (NADAC)$0.970 per gram 0.1% ointment$0.573 per tablet 5 mg tablet
Shortage nowNo current entryNo 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?