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What we now about Tacrolimus

Brand Name(s): FK 506, Prograf

Generic Name Tacrolimus

What are tacrolimus capsules?

TACROLIMUS (Prograf®) is a medication used to decrease the immune system response. Tacrolimus is used to reduce immune responses and prevent rejection in patients who receive organ or bone marrow transplants. Tacrolimus may be used to treat other conditions such as dermatitis, eczema, or psoriasis. Generic tacrolimus capsules are not yet available.

What should my health care professional know before I take tacrolimus capsules?

They need to know if you have any of these conditions:

  • diabetes
  • heart disease or heart failure
  • high blood pressure
  • infection
  • kidney disease
  • an unusual or allergic reaction to tacrolimus, castor oil, other medicines, foods, dyes, or preservatives
  • pregnant or trying to get pregnant
  • breast-feeding

How should I take this medicine?

Take tacrolimus capsules by mouth. Follow the directions on the prescription label. Swallow the capsules with a drink of water. Take with food or milk or take at bedtime to reduce stomach upset. Do not take with grapefruit juice. Taking tacrolimus with food can decrease the amount absorbed, but if you take every dose in the same way this will be acceptable. Take your doses at regular intervals. Do not take your medicine more often than directed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. Contact your prescriber or health care professional if you miss more than one dose, or if you vomit after a dose.

What drug(s) may interact with tacrolimus capsules?

  • aluminum hydroxide
  • amiodarone
  • bosentan
  • bromocriptine
  • certain medicines for HIV-infection such as protease inhibitors
  • cimetidine
  • corticosteroids
  • cyclosporine
  • diltiazem
  • entecavir
  • erythromycin
  • grapefruit juice
  • medicines for diabetes
  • medicines for fungal infections
  • medicines for seizures
  • medicines to control the heart rhythm
  • metoclopramide
  • pamidronate
  • rifabutin
  • rifampin
  • St. John's wort
  • theophylline or aminophylline
  • vaccines
  • verapamil
  • water pills (diuretics)
  • ziprasidone
  • zoledronic acid

Talk to your prescriber or health care professional before taking any of these medicines:

  • aspirin
  • acetaminophen
  • ibuprofen
  • ketoprofen
  • naproxen

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking tacrolimus capsules?

Tacrolimus therapy can produce many side effects. These mainly affect the urinary system and the nervous system. Contact your prescriber or health care professional about any unusual effects. Side effects that you should report to your prescriber or health care professional as soon as possible:

  • signs of infection - fever or chills, cough, sore throat, pain or difficulty passing urine
  • signs of decreased red blood cells - unusual weakness or tiredness, fainting spells, lightheadedness
  • blurred vision, increased sensitivity of the eyes to light
  • burning or tingling in the hands or feet
  • difficulty breathing, wheezing
  • frequent urination
  • increased thirst or hunger
  • ringing in the ears
  • skin rash or itching (hives)
  • seizures (convulsions)
  • stomach, back or general pain
  • swelling of the feet or legs, unusual or sudden weight gain
  • yellowing of skin or eyes

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

  • diarrhea or constipation
  • difficulty sleeping, nightmares
  • dizziness or drowsiness
  • hair loss or unusual hair growth
  • headache
  • loss of appetite
  • mood changes, depression, confusion
  • muscle cramps
  • nausea, vomiting
  • tremor
  • unusual sensitivity to touch

What should I watch for while taking tacrolimus capsules?

Tacrolimus is a strong medication and can produce serious side effects. Discuss the potential risks and benefits with your prescriber or health care professional before you begin taking tacrolimus. Visit your prescriber or health care professional for regular checks on your progress. You will need to have laboratory tests to monitor your therapy with tacrolimus.

After you stop taking this medication, side effects can continue. Some side effects may not occur until years after the medicine was taken. These effects can include the development of certain types of cancer. Discuss this possibility with your prescriber or health care professional.

Tacrolimus will decrease your body's ability to fight infections. Call your prescriber or health care professional if you have a fever, chills, sore throat or other symptoms of a cold or flu. Do not treat these symptoms yourself. Try to avoid being around people who are sick. Do not have any vaccinations without your prescriber's approval. Avoid people who have recently received the oral polio vaccine.

Your blood sugar may increase while you are taking tacrolimus. Call your prescriber or health care professional for advice if you have any of the following symptoms: increased thirst, dry mouth, pass urine frequently, notice a fruity odor on your breath, or feel tired and lose your appetite.

Avoid taking aspirin, acetaminophen (Tylenol®), ibuprofen (Advil®), ketoprofen (Orudis KT®), or naproxen (Aleve®) products as these may mask a fever, unless instructed to by your prescriber or health care professional.

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open. Store at room temperature between 15 and 30 °C (59 and 86 °F). Throw away any unused medicine after the expiration date.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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