Tacrolimus (Systemic)

Brand Names : Prograf

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For tacrolimus, the following should be considered:

Allergies - Tell your health care professional if you have ever had any unusual or allergic reaction to tacrolimus. Also, if you will be receiving this medicine by injection, tell your health care professional if you are allergic to any other substances, such as castor oil.

Pregnancy - Some women have become pregnant and had babies while receiving tacrolimus after an organ transplantation. Some of the newborn babies had temporary kidney problems after birth. Some babies were born prematurely.

Breast-feeding - Tacrolimus passes into breast milk. There is a chance that it causes the same side effects in the baby that it does in the mother. It may be necessary for you to stop breast-feeding during treatment.

Children - This medicine does not cause different types of side effects or problems in children than it does in adults, although some side effects may occur more or less often than they do in adult patients.

Older adults - There is no specific information comparing the use of tacrolimus in the elderly with the use in other age groups. Tacrolimus is not expected to cause different side effects or problems in older people than it does in younger adults. However, older patients may need lower doses of tacrolimus.

Dental - The effects of tacrolimus may cause increased infections and delayed healing. Dental work, whenever possible, should be completed prior to beginning this medicine.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking tacrolimus, it is especially important that your health care professional knows if you are taking any of the following:

• Amiloride or
• Spironolactone (e.g., Aldactone) or
• Triamterene (e.g., Dyrenium) - Since both tacrolimus and these medicines increase the amount of potassium in the body, potassium levels could become too high

• Cyclosporine (e.g., Neoral) - May increase the effects of tacrolimus by increasing the amount of this medicine in the body; may cause kidney problems

• Danazol (e.g., Danocrine) or
• Erythromycin (medicine for infection) or
• Fluconazole (e.g., Diflucan) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) - May increase the effects of tacrolimus by increasing the amount of this medicine in the body

• Rifampin (e.g., Rifadin) - May decrease the effects of tacrolimus by decreasing the amount of this medicine in the body

Other medical problems - The presence of other medical problems may affect the use of tacrolimus. Make sure you tell your doctor if you have any other medical problems, especially:

• Cancer - Tacrolimus can make this condition worse

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles) - Risk of severe disease affecting other parts of the body

• Diabetes mellitus (sugar diabetes) - Tacrolimus can increase the amount of sugar in the blood

• Hepatitis or
• Kidney disease or
• Liver disease, other - Tacrolimus can have harmful effects on the kidney in patients with these conditions; a lower dose of tacrolimus may be needed in patients with these conditions

• Hyperkalemia (high amount of potassium in the blood) or
• Nervous system problems - Tacrolimus can make these conditions worse

• Infection - Tacrolimus decreases the body's ability to fight infection