Tacrolimus and Asciminib: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Tacrolimus
Asciminib
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased exposure to CYP3A4/P-gp substrates and increased risk of CYP3A4/P-gp substrates-related adverse effects
Interaction Deep Dive
Asciminib is a CYP3A4 and P-gp inhibitor. Concomitant use of asciminib with a dual P-gp and CYP3A4 substrate having NTI increases the Cmax and AUC of these substrates, where minimal concentration changes may lead to serious adverse reactions. Avoid coadministration of asciminib at 200 mg twice daily with CYP3A4 substrates having NTI. Closely monitor for adverse reactions in patients treated with asciminib at all recommended doses with concomitant use of dual P-gp and CYP3A4 substrate having NTI1.
Why it happens (mechanism)
Inhibition of CYP3A4-substrate metabolism by asciminib; inhibition of P-gp mediated efflux transport by asciminib
Literature reports
1 report — tap to read
a) The midazolam AUC (infinity) and Cmax increased by 28% and 11%, respectively, following coadministration of a CYP3A4 substrate (midazolam) with asciminib 40 mg twice daily. The midazolam AUC (infinity) and Cmax increased by 24% and 17%, respectively, following coadministration with asciminib at 80 mg once daily and 88% and 58%, respectively, at 200 mg twice daily 1.
Common questions
Can I take Tacrolimus and Asciminib together?
Increased exposure to CYP3A4/P-gp substrates and increased risk of CYP3A4/P-gp substrates-related adverse effects Always confirm with your pharmacist or prescriber before making any change.
How serious is the Tacrolimus and Asciminib interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Tacrolimus or Asciminib need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: SCEMBLIX(R) oral tablets, asciminib oral tablets. Novartis Pharmaceuticals Corporation (per FDA), East Hanover, NJ, 2023. DailyMed
Keep reading about Tacrolimus
Keep reading about Asciminib
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