Tacrolimus Topical and Ketoconazole Interaction
Drug interaction information between Tacrolimus Topical and Ketoconazole.
Tacrolimus Topical and Ketoconazole have a documented moderate interaction in FDA labeling.
FDA drug labeling documents a moderate-severity interaction between Tacrolimus Topical and Ketoconazole. This page displays the available source-record category and label text. The category is not an individual risk estimate or medication-combination direction.
How They Interact
Ketoconazole is a strong blocker of the enzyme that clears tacrolimus from your body, leading to much higher levels of the drug in your system.
FDA Label Information
Strong CYP3A Inhibitors : Protease inhibitors (e.g., nelfinavir, telaprevir, boceprevir, ritonavir), azole antifungals (e.g., voriconazole, posaconazole, itraconazole, ketoconazole), antibiotics (e.g., clarithromycin, troleandomycin, chloramphenicol), nefazodone, letermovir, Schisandra sphenanthera extracts May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation).
Tacrolimus Topical Also Interacts With
- Omeprazole moderate
- Estradiol moderate
- Diltiazem moderate
- Nifedipine moderate
- Verapamil moderate
Ketoconazole Also Interacts With
- Alfuzosin major
- Dronedarone major
- Ranolazine major
- Saxagliptin major
- Sildenafil major
Frequently Asked Questions
What SPL severity band is on file for Tacrolimus Topical + Ketoconazole?
Compiled FDA labeling labels this pair moderate. That is a source-record field, not an individual medication-combination decision.
Which drug in this pair has the larger labeled-interaction portfolio?
Ketoconazole has 113 labeled pairs on file vs Tacrolimus Topical's 25. In the moderate band specifically: Tacrolimus Topical has 19 (also Omeprazole, Estradiol, Diltiazem, Nifedipine); Ketoconazole has 22 (also Alprazolam, Aprepitant, Budesonide/Formoterol, Dexamethasone).
What mechanism field is on file for Tacrolimus Topical and Ketoconazole?
Ketoconazole is a strong blocker of the enzyme that clears tacrolimus from your body, leading to much higher levels of the drug in your system.
Ketoconazole carries more major-labeled pairs than Tacrolimus Topical
SPL source-record counts only. This page's band is moderate · classes on file: Tacrolimus Topical (Calcineurin Inhibitor (Topical)); Ketoconazole (Azole Antifungal).
Ketoconazole has 6 major-labeled pairs vs Tacrolimus Topical's 0. This page itself is in the moderate band, not the major band.
0 major · 19 moderate · 6 minor · 25 total
- Other moderate peers for Tacrolimus Topical
- Omeprazole
- Estradiol
- Diltiazem
- Nifedipine
6 major · 22 moderate · 85 minor · 113 total
- Other moderate peers for Ketoconazole
- Alprazolam
- Aprepitant
- Budesonide/Formoterol
- Dexamethasone
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. This registry does not provide individual medication-combination directions.
Read our methodology - how this data is sourced, computed, and verified.