Drug & supplement interaction

Hemp + Tacrolimus

Tacrolimus brand names: Prograf (capsule), Prograf (injectable), Protopic, Prograf XL, Astagraf XL, and others.

Minor Interaction
The bottom line Minor

Hemp has a minor interaction with Tacrolimus. Theoretically, hemp might decrease the levels and clinical effects of CYP3A4 substrates.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Hemp and Tacrolimus

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Tacrolimus

Tacrolimus falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Hemp interacts with.

Theoretically, hemp might decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that hemp induces CYP3A4 enzymes.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the idea behind this pairing. Your body clears tacrolimus using a liver enzyme called CYP3A4. Lab studies (not human studies) hint that hemp might speed up that enzyme. If that happened in real life, your tacrolimus could break down faster and drop to lower blood levels than your transplant team intended.

Why that matters: tacrolimus is a narrow therapeutic index drug, meaning small shifts in its level are a big deal. Levels that dip too low could leave your transplanted organ at risk of rejection. The good news is this evidence is only theoretical and weak right now, and food amounts of hemp seeds are unlikely to cause trouble. Still, because your dose is carefully fine-tuned, please check with your pharmacist or transplant doctor before adding any hemp product.

References
  1. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Hemp Also Interacts With Other Medications

Hemp has 41 moderate, 896 minor known drug interactions in our database — the Tacrolimus one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Hemp

Covers the 2,830 medications we’ve checked against Hemp. Pick one to open its full report.

From our Q&A

Questions About Hemp or Tacrolimus

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Hemp or Tacrolimus, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Tacrolimus

This page covers Hemp only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tacrolimus page lists 202 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Asarabacca (major) and Cesium (major).

By severity: 11 major · 152 moderate · 39 minor.

From our pharmacist’s overview on the Tacrolimus page

“Tacrolimus (Prograf, Astagraf XL, Envarsus XR) keeps a transplanted organ from being rejected, and it works inside a narrow blood-level window, meaning even small shifts can invite rejection or toxicity. That makes these 202 supplement interactions worth real caution.”

Reviewed by 2 · Jul 18, 2026

Open the Tacrolimus interaction page

One more smart check

Taking Hemp as Part of a Dietary Supplement Product? Check It for Interactions

We hold 720 real supplement products containing Hemp, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Hemp. Your product may carry other ingredients that interact with Tacrolimus too, on top of Hemp — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Hemp and Tacrolimus Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Hemp
Top 25%

#174 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tacrolimus
Top 25%

#382 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Hemp

What is Hemp?

Hemp
  • Plant-based protein source
  • Heart health support
  • Skin and hair health
  • Reducing inflammation
  • General nutrition (omega fatty acids)

Hemp seeds and hemp seed oil are nutritious foods rich in protein, fiber, and healthy omega-3 and omega-6 fatty acids, and they are generally safe for most people as part of the diet. While the nutrition is real, strong human evidence that hemp supplements treat specific medical conditions is limited. Talk with your pharmacist or doctor before using hemp products for a health concern, especially if you are pregnant or breastfeeding.

Read the full Hemp monograph & all interactions
Medication

About Tacrolimus

What Is Tacrolimus Used For?

Brand names: Prograf (capsule), Prograf (injectable), Protopic, Prograf XL, Astagraf XL, Envarsus XR

Tacrolimus is prescribed to help prevent your body from rejecting a transplanted organ. It is used in adults who receive a kidney, liver, or heart transplant, and in children who receive a liver transplant. It is always used alongside other anti-rejection medicines.

Because tacrolimus works by dampening your immune system, it lowers the risk of your body attacking the new organ — but it also means you need to be watched closely for infections and other side effects throughout your treatment.

See full Tacrolimus drug information
Keep checking

Other Drugs & Hemp

Browse every other medication we’ve checked against Hemp — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
41Moderate
896Minor
1,892No known interaction
Moderate

41 interactions

Minor

896 interactions

Showing 60 of 896 minor interactions — see all 896 on the Hemp page.

No interaction 1,892 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Hemp and Tacrolimus Together: Common Questions

Can you take Hemp with Tacrolimus?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Hemp and Tacrolimus interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tacrolimus and Hemp?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.