What the FDA labels say about taking them together
Carbamazepine and tacrolimus
Carbamazepine's FDA label of August 20, 2026 names tacrolimus in its drug interactions section, and tacrolimus's label names carbamazepine too. The tacrolimus label: “Increase PROGRAF dose and monitor tacrolimus whole blood trough concentrations.”
Check it at the source: the carbamazepine FDA label on DailyMed (effective August 20, 2026, Novartis Pharmaceuticals Corporation); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the carbamazepine label say about tacrolimus?
Carbamazepine label, drug interactionsWhen carbamazepine is used with tacrolimus, monitoring of tacrolimus blood concentrations and appropriate dosage adjustments are recommended.
Source: FDA drug label (Equetro, NDA021710), Validus Pharmaceuticals LLC, effective August 19, 2025 (SPL set be478f3c-40f6-47cc-8ab9-f420a9372b1c), via openFDA
Source: FDA drug label (Tegretol), Novartis Pharmaceuticals Corporation, effective August 20, 2026 (SPL set 8d409411-aa9f-4f3a-a52c-fbcb0c3ec053), via openFDA; the full label on DailyMed
What does the tacrolimus label say about carbamazepine?
Tacrolimus label, drug interactionsDrug/Substance Class or Name: Strong CYP3A Inducers 3: Antimycobacterials (e.g., rifampin, rifabutin), anticonvulsants (e.g., phenytoin, carbamazepine and phenobarbital), St John's wort; Drug Interaction Effect: May decrease tacrolimus whole blood trough concentrations and increase the risk of rejection [see)].; Recommendations: Increase tacrolimus dose and monitor tacrolimus whole blood trough concentrations [ see,) and ].
Prograf label (Astellas Pharma US, Inc., August 25, 2023), drug interactionsDrug/Substance Class or Name: Strong CYP3A Inducers Strong CYP3A inhibitor/inducer, based on reported effect on exposures to tacrolimus along with supporting in vitro CYP3A inhibitor/inducer data, or based on drug-drug interaction studies with midazolam (sensitive CYP3A probe substrate).: Antimycobacterials (e.g., rifampin, rifabutin), anticonvulsants (e.g., phenytoin, carbamazepine and phenobarbital), St John’s wort; Drug Interaction Effect: May decrease tacrolimus whole blood trough concentrations and increase the risk of rejection [see ()].; Recommendations: Increase PROGRAF dose and monitor tacrolimus whole blood trough concentrations [see (,) and ()].
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
| Carbamazepine | Tacrolimus | |
|---|---|---|
| Labeled for | Bipolar disorder, Seizures and epilepsy | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.119 per tablet 200 mg tablet | $0.970 per gram 0.1% ointment |
| Shortage now | A presentation being discontinued | 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