This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Immunomodulatory: DMARDS, Monoclonal Antibodies, Subject name: Pharmacology
Tacrolimus level is increased by all except 
Select and explain. 
A. Erythromycin, B. Itraconazole, C. Danazole, D. Rifampicin
D: Rifampicin
Answer: D: Rifampicin 
Explanation: Ans. (D) Rifampicinwww.medscape.com/druginfo(Ref: KDT 8/e p940, )Erythromycin, itraconazol and danazol inhibit the metabolism of tacrolimus and thus increase the plasma concentration whereas rifampicin is an enzyme inducer and decrease its plasma level.