I am on Tacrolimus. The one time my liver enzymes spiked was when I took a homeopathic sinus remedy...and, my doctor was very upset! I can’t tell you why your Tacrolimus dose has been modified over the years. However, I’m now 8 months out from my liver transplant and my dose has been reduced from 8mg/day to 6 mg/day; my Mycophenolate has been doubled to 2,000 mg/day. But there are less side effects with it.

For several months now I’ve taken my meds at 8 am before I eat and wait at least an hour before eating. I take my meds at 8 pm at least 2 hours after finishing supper. I’ve read that Tacrolimus is far better metabolized on an empty stomach and consistency is important. Also, I take no supplements, herbal or prescription remedies without approval from my nurse. There are more than 700 foods, herbal interactions, meds, that can increase or inhibit the metabolism of Tacrolimus in your body. I also consult Drugs.com to check. The dose of Tacrolimus we take is based on how much is in your system when you take it, and of course your monitored enzymes. At least that’s for liver transplant folks.

Apologies, if you’re already aware of these interactions, but I wasn’t informed of how many there are until I researched. This is a good article, it’s about Cyclosporine, but it’s the same for Tacrolimus -
https://www.hindawi.com/journals/jt/2014/145325/