What the FDA labels say about taking them together
Cyclosporine and tacrolimus
Cyclosporine's FDA label of August 10, 2026 names tacrolimus in its drug interactions section, and tacrolimus's label names cyclosporine too. The tacrolimus label: “Mycophenolic Acid Products: Can increase MPA exposure after crossover from cyclosporine to PROGRAF; monitor for MPA-related adverse reactions and adjust MMF or MPA dose as needed.”
Check it at the source: the cyclosporine FDA label on DailyMed (effective August 10, 2026, Novartis Pharmaceuticals Corporation); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the cyclosporine label say about tacrolimus?
Cyclosporine label, drug interactionsciprofloxacin; melphalan; amphotericin B; azapropazon; cimetidine; tacrolimus; fibric acid derivatives (e.g., bezafibrate, fenofibrate)
Source: FDA drug label (Neoral), Novartis Pharmaceuticals Corporation, effective August 10, 2026 (SPL set 94461af3-11f1-4670-95d4-2965b9538ae3), via openFDA; the full label on DailyMed
What does the tacrolimus label say about cyclosporine?
Tacrolimus label, drug interactionsDRUG INTERACTIONS Mycophenolic Acid Products: Can increase MPA exposure after crossover from cyclosporine to tacrolimus; monitor for MPA-related adverse reactions and adjust MMF or MPA dose as needed. ( 7.1 ) Nelfinavir and Grapefruit Juice:
Astagraf Xl label (Astellas Pharma US, Inc., January 14, 2026), drug interactionsMycophenolic Acid When ASTAGRAF XL is prescribed with a given dose of a mycophenolic acid (MPA) product, exposure to MPA is higher with ASTAGRAF XL co-administration than with cyclosporine co-administration with MPA, because cyclosporine interrupts the enterohepatic recirculation of MPA while tacrolimus does not.
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
| Cyclosporine | Tacrolimus | |
|---|---|---|
| Labeled for | Organ transplant rejection, Rheumatoid arthritis | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $1.04 per unit 0.05% eye emulsion | $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