Is Grapefruit / Grapefruit Juice Safe with tacrolimus?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Do not eat grapefruit or drink grapefruit juice while taking tacrolimus.
Why this interaction occurs
Grapefruit and grapefruit juice inhibit CYP3A and may increase tacrolimus whole blood trough concentrations, raising the risk of serious adverse reactions including neurotoxicity and QT prolongation. High-dose/double-strength grapefruit juice is a strong CYP3A inhibitor; low-dose/single-strength is a moderate CYP3A inhibitor.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 130,929 reports mentioning tacrolimus. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the tacrolimus + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Grapefruit / Grapefruit Juice interactions → · All tacrolimus interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.