SSRIs Tacrolimus

A4 Amiodarone, azole antifungals, cimetidine, clarithromycin, cyclosporine, erythromycin, fluoroquinolones, grapefruit juice, HIV protease inhibitors, metronidazole, quinine. SSRIs, tacrolimus Antiarrhythmics, antidepressants, azole antifungals, benzodiazepines, calcium channel blockers, cyclosporine, delavirdine, doxorubicin, efavirenz, erythromycin, estrogens, HIV protease inhibitors, nefazodone. paclitaxel, proton pump inhibitors, HMG-CoA reductase inhibitors, rifabutin, rifampin, sildenafil, SSRIs, tamoxifen, trazodone, vinca anticancer agents... 

Fluvoxamine is an inhibitor of CYP3A4 and so theoretically could affect the metabolism of tacrolimus. Close monitoring of tacrolimus levels is therefore advised. Paroxetine and sertraline and possibly other SSRIs may be suitable alternative antidepressants, but the evidence is slim, so additional monitoring may still be warranted. Further study on the use of antidepressants with tacrolimus is needed. 

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