Class landing · Immunosuppressants

Supplements and immunosuppressants.

Tacrolimus, ciclosporin, sirolimus, everolimus and the CYP3A4 substrates that put transplant patients at risk.

Transplant immunosuppressants (tacrolimus, ciclosporin, sirolimus, everolimus) have very narrow therapeutic windows. They are metabolised by CYP3A4. Any supplement that inhibits or induces CYP3A4 shifts blood levels in a way that risks either toxicity or graft rejection. This is the highest-stakes category in our database.

Hard exclusions: curcumin, quercetin, resveratrol, schisandra, and St John’s Wort all act on CYP3A4 and are off the table on these drugs. Immune-stimulating supplements (echinacea, andrographis, elderberry, astragalus, cordyceps) are also avoided in transplant patients because they may counteract the deliberate immunosuppression. Anything you consider should go through the transplant team first.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

Your supplements

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Your medications

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Anything we should know? (optional)

Pick any that apply. We adjust the findings where context changes the answer.

I confirm I am 18 or over. This tool gives evidence-graded information, not medical advice; always discuss changes with your GP or pharmacist.

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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

Read the full methodology

Your whole stack

Want this checked across everything you take?

This page checks the pairs you enter. The personalised Distil report goes further:

the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
where your current routine may be leaving you short of your goals
the evidence-backed compounds worth adding, and the ones worth dropping

It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.

See a real sample report

Something missing?

If a supplement or medication you take isn't in our autocomplete, tell us. We go through what people flag every week and add what's missing.

Thanks, that's logged. We go through flagged items every week.

Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.