Tacrolimus Injection

What is this medication?

TACROLIMUS (ta KROE li mus) prevents the body from rejecting an organ transplant. It works by lowering the body's immune system response. This helps the body accept the donor organ. It belongs to a group of medications called immunosuppressants.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Prograf

What should I tell my care team before I take this medication?

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

• Diabetes
• Heart disease
• High blood pressure
• Immune system problems
• Infection
• Kidney disease
• Liver disease
• Recent or upcoming vaccine
• An unusual or allergic reaction to tacrolimus, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is injected into a vein. It is given by a care team in a hospital or clinic setting.

Talk to your care team about the use of this medication in children. While it may be given to children for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply.

What may interact with this medication?

Do not take this medication with any of the following:

• Cidofovir
• Cyclosporine
• Dronedarone
• Fluconazole
• Grapefruit juice
• Ketoconazole
• Levoketoconazole
• Live virus vaccines
• Mifepristone
• Pimozide
• Saquinavir
• Thioridazine
• Ziprasidone

This medication may also interact with the following:

• Cannabidiol
• Certain antibiotics, such as clarithromycin, gentamicin, neomycin, rifabutin, rifampin
• Certain antivirals for HIV or hepatitis
• Certain medications for blood pressure, heart disease, irregular heartbeat, such as diltiazem, enalapril, losartan
• Certain medications for fungal infections, such as amphotericin B, caspofungin, itraconazole, voriconazole
• Cisplatin
• Cyclosporine
• Diuretics
• Ganciclovir
• Letermovir
• Other medications that cause heart rhythm changes, such as amiodarone
• Sirolimus
• St. John's wort

This medication may affect how other medications work, and other medications may affect the way this medication works. Talk with your care team about all of the medications you take. They may suggest changes to your treatment plan to lower the risk of side effects and to make sure your medications work as intended.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Your condition will be monitored carefully while you are receiving this medication.

This medication may increase your risk of getting an infection. Call your care team for advice if you get a fever, chills, sore throat, or other symptoms of a cold or flu. Do not treat yourself. Try to avoid being around people who are sick.

Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects. A reliable form of contraception is recommended before starting and while taking this medication. Talk to your care team about reliable forms of contraception.

Males who take this medication must use a condom during sex. Tell your care team right away if your partner becomes pregnant while you are taking this medication.

Talk to your care team about your risk of cancer. You may be more at risk for certain types of cancers if you take this medication.

This medication can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and sunscreen. Do not use sun lamps or tanning beds/booths.

This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication.

Avoid taking medications that contain aspirin, acetaminophen, ibuprofen, naproxen, or ketoprofen unless instructed by your care team. These medications may hide a fever.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Dizziness, loss of balance or coordination, confusion or trouble speaking
• Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• High potassium level—muscle weakness, fast or irregular heartbeat
• Increase in blood pressure
• Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
• Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
• Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
• Stomach pain, bloody diarrhea, pale skin, unusual weakness or fatigue, decrease in the amount of urine, which may be signs of hemolytic uremic syndrome
• Sudden and severe headache, confusion, change in vision, seizures, which may be signs of posterior reversible encephalopathy syndrome (PRES)
• TTP—purple spots on the skin or inside the mouth, pale skin, yellowing skin or eyes, unusual weakness or fatigue, fever, fast or irregular heartbeat, confusion, change in vision, trouble speaking, trouble walking

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

• Constipation
• Diarrhea
• Pain, tingling, or numbness in the hands or feet
• Tremors or shaking
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

This medication is given in a hospital or clinic. It will not be stored at home.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.