calcineurin inhibitor
2 interactions related to calcineurin inhibitor
cbd + tacrolimus
CBD inhibits CYP3A4, CYP3A5, and P-glycoprotein, the main pathways that clear tacrolimus. Case reports and a controlled pharmacokinetic trial show that adding CBD raises tacrolimus blood levels substantially, risking nephrotoxicity, neurotoxicity, and over-immunosuppression in transplant recipients, while stopping CBD abruptly can let levels crash and risk rejection.
lactobacillus + tacrolimus
Tacrolimus is a calcineurin-inhibitor immunosuppressant used after solid-organ transplant. In immunosuppressed transplant recipients, Lactobacillus probiotic organisms can cross the gut wall and cause bloodstream infection. Published case reports document Lactobacillus rhamnosus bacteremia in renal transplant patients on tacrolimus, and many probiotic strains are intrinsically vancomycin-resistant, making treatment harder.