What the FDA labels say about taking them together
Lansoprazole and tacrolimus
Lansoprazole's FDA label of June 24, 2025 names tacrolimus in its drug interactions (prescription label) section, and tacrolimus's label names lansoprazole too. The tacrolimus label: “Monitor tacrolimus whole blood trough concentrations and reduce ASTAGRAF XL dose if needed.”
Check it at the source: the lansoprazole FDA label on DailyMed (effective June 24, 2025, L. Perrigo Company); the tacrolimus FDA label on DailyMed (effective July 17, 2026, Stellon Biotech Inc.).
What does the lansoprazole label say about tacrolimus?
Lansoprazole label, drug interactions (prescription label)Tacrolimus Clinical Impact: Potentially increased exposure of tacrolimus, especially in transplant patients who are intermediate or poor metabolizers of CYP2C19. Intervention: Monitor tacrolimus whole blood trough concentrations. Dose adjustment of tacrolimus may be needed to maintain therapeutic drug concentrations. See prescribing information for tacrolimus.
Source: FDA drug label (Prevacid 24 HR), L. Perrigo Company, effective June 24, 2025 (SPL set 205c9c1e-b422-4e86-a4b0-714b608adc19), via openFDA; the full label on DailyMed
What does the tacrolimus label say about lansoprazole?
Tacrolimus label, drug interactionsDrug/Substance Class or Name: Mild or Moderate CYP3A Inhibitors: Clotrimazole, antibiotics (e.g., erythromycin, fluconazole), calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, nicardipine), amiodarone, danazol, ethinyl estradiol, cimetidine, lansoprazole and omeprazole; Drug Interaction Effect: May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see,,)].; Recommendations: Monitor tacrolimus whole blood trough concentrations and reduce tacrolimus dose if needed [ see,) and ].
Envarsus Xr label (Veloxis Pharmaceuticals, Inc, February 26, 2025), drug interactionsDrug/Substance Class or Name: Mild or Moderate CYP3A Inhibitors, such as: antibiotics (e.g., erythromycin), calcium channel blockers (e.g., verapamil, diltiazem, nifedipine, nicardipine), amiodarone, danazol, ethinyl estradiol, cimetidine, lansoprazole and omeprazole, azole antifungals (e.g., clotrimazole, fluconazole, isavuconazole), imatinib, nilotinib, letermovir; Drug Interaction Effect: May increase tacrolimus whole blood trough concentrations and increase the risk of serious adverse reactions (e.g., neurotoxicity, QT prolongation) [see,, ].; Recommendations: Monitor tacrolimus whole blood trough concentrations and reduce ENVARSUS XR dose if needed [see and ].
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
| Lansoprazole | Tacrolimus | |
|---|---|---|
| Labeled for | Acid reflux and ulcers | Organ transplant rejection, Eczema (atopic dermatitis) |
| Boxed warning | No | Yes |
| Pharmacy cost (NADAC) | $0.106 per capsule 30 mg capsule | $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