Tacrolimus is the generic version of the brand name drug Prograf, which is used along with other medicines to prevent organ rejection in people who've had a kidney, liver, or heart transplant.
The drug is also sometimes used to treat Crohn's disease (a condition where the body attacks the lining of the digestive tract).
Prograf (tacrolimus) is an immunosuppressant. It works by blocking the action of certain blood cells that can prompt the body to reject a transplanted organ.
The Food and Drug Administration (FDA) approved tacrolimus in 1994. Prograf is manufactured by Astellas Pharma US.
Tacrolimus contains a black-box warning because it may increase your risk of infection and your chances of developing skin cancer or lymphoma.
Tell your doctor right away if you notice any of the following symptoms while taking tacrolimus:
To lower your risk of skin cancer, avoid tanning beds and unnecessary exposure to sunlight while taking this drug. Wear protective clothing and sunscreen if you must be outdoors.
This medicine should only be given under the supervision of a physician who is experienced in treating organ transplant patients and administering drugs that decrease the activity of the immune system.
Before taking tacrolimus, tell your doctor if you have or have had:
Be sure to tell your physician about all the drugs you take. Some medications may increase your chances of developing QT prolongation (a type of irregular heartbeat).
Also, tell your healthcare provider if you take or if you've recently stopped taking the drug Gengraf, Neoral or Sandimmune (cyclosporine).
Your physician will probably tell you not to start tacrolimus until 24 hours after your last dose of cyclosporine.
Tacrolimus may cause high blood pressure. Your doctor will need to monitor your blood pressure carefully during your treatment.
The medicine may also increase your chances of developing diabetes during treatment. Hispanics and African Americans who've had kidney transplants are at an especially high risk.
Tell your physician if you or anyone in your family has ever had diabetes, and tell your doctor immediately if you experience any of the following symptoms:
Let your healthcare provider know you're taking this medicine before having any type of surgery, including a dental procedure.
Don't receive any vaccination while taking tacrolimus without first talking to your doctor.
Continue to take tacrolimus even if you feel well. Don't stop using this medicine without first talking to your doctor.
Keep all appointments with your healthcare provider while taking this drug. Your doctor will want to frequently monitor your body's response to the therapy.
Tacrolimus may cause harm to an unborn baby.
Tell your doctor if you're pregnant or might become pregnant before taking this medicine.
The drug can be found in breast milk. Don't breastfeed a baby while taking tacrolimus.
Tell your doctor if any of the following side effects are severe or don't go away:
Tell your doctor immediately if you experience any of the symptoms listed in the Warning section or any of the following serious side effects:
Tell your doctor about all prescription, non-prescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking before taking tacrolimus, especially those listed in the Warning section or any of the following:
Tacrolimus may cause dizziness. Don't drive or operate machinery until you know how the drug affects you.
Alcohol may worsen certain side effects of tacrolimus.
Talk to your doctor before consuming alcohol while taking this medicine.
Grapefruit and grapefruit juice may interfere with how tacrolimus works in the body.
Talk to your doctor about this potential interaction.
Tacrolimus comes as a capsule to take by mouth or as a solution to be injected into a vein.
Follow your doctor's instructions carefully when taking or receiving tacrolimus. Don't use more or less of the drug than is recommended.
Whole blood levels can be monitored in patients who take tacrolimus to ensure they're taking the correct dose and to decrease the risk of adverse effects.
The capsules are typically taken twice a day.
Try to space your doses about 12 hours apart, and take this medicine around the same time each day.
The injection of tacrolimus is usually administered at a doctor's office, hospital, or clinic. This formulation is typically reserved for patients who can't tolerate taking the medicine by mouth.
It's typically given as an ongoing infusion beginning no sooner than six hours after transplant surgery and continuing until the medicine can be taken orally.
Symptoms of a tacrolimus overdose may include hives or sleepiness.
If you suspect an overdose, contact a poison control center or emergency room immediately.
You can get in touch with a poison control center at 800-222-1222.
If you miss a dose of tacrolimus, take it as soon as you remember.
However, skip the missed dose if it's almost time for your next scheduled dose. Don't take extra medicine to make up for a missed dose.
If you miss an injection of tacrolimus, tell your doctor right away.
A: Prograf (tacrolimus) is indicated for the prophylaxis of organ rejection in patients receiving allogeneic liver, kidney, or heart transplants. The most common side effects of Prograf include tremor, headache, hypertension (high blood pressure), gastrointestinal disturbance, abnormal renal (kidney) function, hyperglycemia (increase in blood sugar levels), leukopenia (decrease in white blood cells), cytomegalovirus (CMV) infection, infection, and hyperlipidemia (increase in blood cholesterol levels). When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting www.fda.gov/medwatch or by calling 1-800-FDA-1088. Shereen A. Gharbia, PharmD
A: Prograf (tacrolimus) is used in combination with other medications to prevent the body from rejection after a heart, liver or kidney transplant. Prograf lowers the body
By Lynn Marks | Medically Reviewed by Robert Jasmer, MD
Latest Update: 2015-11-03