Brand name: Prograf
Class of drugs: Immunosuppressant

Why is tacrolimus prescribed?
Tacrolimus is prescribed to transplant patients in order to prevent organ rejection. Upon receiving an organ transplant, the patient's body's white blood cells will try to get rid of (reject) the transplanted organ. Tacrolimus suppresses the body's immune system to prevent this from happening.

How is tacrolimus given?
This medication either comes in the form of a tablet and is swallowed, or is given by injection. Dosage varies with individuals. Tacrolimus should be taken exactly as your doctor has directed. You will need to take immunosuppressant drugs every day for the rest of your life to prevent transplant rejection. Do not take more or less than the recommended does.

Tacrolimus works best when it is constantly in the bloodstream and you should try to take it around the same time each day. Absorption of this drug may be affected by changes in your diet, and you should not change the type or amount of food you eat without first consulting your doctor.

Are there any special precautions I should follow before taking tacrolimus?
Before taking tacrolimus, inform your doctor:

• Of any prescription or over-the-counter medications that you are currentlytaking; this includes any herbal medications or supplements that you are taking.
• If you have any allergies.
• If you have chickenpox (or were recently exposed to it), cancer, diabetes mellitus, hepatitis, shingles, hyperkalemia (high potassium levels in your blood), nervous system problems or any infection.

What special instructions should I follow while using this drug?

• Keep all appointments with your doctor and the laboratory so that your response can be monitored. You will have frequent blood tests to monitor tacrolimus in your system. These blood tests will also help your doctor adjust the dosage of the medication if necessary.
• Do not eat raw oysters or other raw shellfish. These may contain bacteriat that can cause serious illness or even death for people with weakened immune systems. Be sure that all shellfish you eat is fully cooked.
• Do not eat grapefruit or drink grapefruit juice while you are taking tacrolimus. Grapefruit may increase the effects of this drug by increasing the amount of it in your system.
• Do not have any immunizations or vaccinations without your doctor’s approval.
• Because your immune system is diminished, try to avoid people with colds and other infections.
• Be sure that you have enough medication on hand. Check your supply before holidays or other occasions where you may be unable to fill your prescription. If you must travel outside the country, keep in mind that tacrolimus is not approved and may not be available in all countries.

Keep all appointments with your doctor and the laboratory so that your response can be monitored. You will have frequent blood tests to monitor tacrolimus in your system. These blood tests will also help your doctor adjust the dosage of the medication if necessary.

What are the common side effects?
The most common side effects from taking tacrolimus include:

• Increased risk of infection
• Hyperkalemia
• Hypomagnesemia
• High cholesterol
• Hypertension

When should I call my doctor?
If you experience any of the following symptoms, call your doctor immediately:

• Abdominal pain
• Abnormal dreams
• Anxiety
• Chills
• Confusion
• Seizures
• Diarrhea
• Dizziness
• Fever and sore throat
• Frequent urination
• Unusual bleeding or bruising

What should I do if I forget a dose?
If you have missed your dose by less than 3 hours, simply take your missed dose. However, if it is close to when you are scheduled to take your next dose, simply skip the missed dose and proceed with your regular schedule. Do not take a double dose.

What storage conditions are necessary for this drug?
Tacrolimus should be kept in its original container, tightly sealed and away from children. It should be stored in room temperature, away from excess heat and moisture (not in the bathroom) and out of direct sunlight. Throw away any medication that is outdated or unused.

For More Information
If you have any questions or concerns, please call us at 216.444.8282. We will be happy to answer your questions.