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Prograf (Tacrolimus) is an immunosuppressant. It blocks the action of certain blood cells (eg, T lymphocytes) that can cause the body to reject the transplanted organ.

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Uses

Tacrolimus (tak-ROE-li-mus) is used for preventing organ rejection in patients following liver, kidney, or heart transplant. It may be used along with other medicines. It may also be used for other conditions as determined by your doctor.

How to take

You may take Tacrolimus by mouth on an empty stomach or with food. However, you must take it the same way each time for it to work best. If you take Tacrolimus on an empty stomach, always take it on an empty stomach. If you take it with food, always take it with food. Grapefruit and grapefruit juice may increase the risk of side effects from Tacrolimus. Talk to your doctor before including grapefruit or grapefruit juice in your diet while taking Tacrolimus. Tacrolimus works best if it is taken at the same time each day. Continue to take Tacrolimus even if you feel well. Do not miss any doses.

Side effects

Check with your doctor if any of these most common side effects persist or become bothersome: Back pain, constipation, diarrhea, dizziness, headache, joint pain, loss of appetite, nausea, stomach pain or upset; trouble sleeping, vomiting. Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion, dark urine, decreased coordination, chest pain, diabetes (frequent urination, increased thirst or hunger); fast or irregular heartbeat; mental or mood changes (eg, anxiety, confusion); one-sided weakness; painful urination or changes in the amount of urine; red, swollen, blistered, or peeling skin; seizures, severe or persistent dizziness or headache; shortness of breath, swelling of the hands, feet, or legs; tingling or numbness in the hands or feet; tremor, unusual bruising or bleeding; unusual lumps or skin lesions; unusual weakness or tiredness; vision changes, yellowing of skin or eyes. This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider.

Precaution

Tacrolimus decreases the action of the immune system. This may increase your risk of infection. It may also increase your risk for developing certain types of cancer (eg, lymphoma). Tell your doctor right away if you notice signs of infection (eg, persistent sore throat, chills, fever) or unusual growths or lumps. Do NOT use Tacrolimus if: you are allergic to any ingredient in this medicine or you have taken cyclosporine within the last 24 hours Contact your doctor or health care provider right away if any of these apply to you. Tell your doctor or pharmacist if you have heart, kidney, or liver problems; diabetes; or high potassium levels in your blood. Ask your health care provider any questions you may have about how to use Tacrolimus. Tacrolimus may cause drowsiness and dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Tacrolimus with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it. Do not change your dose of Tacrolimus without first checking with your doctor. Tacrolimus may increase your risk for developing skin cancer. Avoid using sunlamps or tanning booths. Limit your exposure to the sun. Use a sunscreen or wear protective clothing if you must be outside for more than a short time. Check with your doctor before you drink alcohol while you are taking Tacrolimus. Check with your doctor before you use a salt substitute or a product that has potassium in it. Tacrolimus may lower the ability of your body to fight infection. Avoid contact with people who have colds or infections. Tell your doctor if you notice signs of infection like fever, sore throat, rash, or chills. Do not receive a live vaccine (eg, measles, mumps) while you are taking Tacrolimus. Talk with your doctor before you receive any vaccine. Patients who take Tacrolimus after an organ transplant may have an increased risk for developing high blood sugar or diabetes. The risk is higher among black and Hispanic patients after a kidney transplant. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make your flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away. Lab tests, including blood counts, blood potassium and glucose levels, kidney function, heart function, and blood pressure may be performed while you use Tacrolimus. These tests may be used to monitor your condition or check for side effects. Tacrolimus has been shown to cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Tacrolimus while you are pregnant. Tacrolimus is found in breast milk. Do not breast-feed while taking Tacrolimus.

Drug interactions

Tell your health care provider if you are taking any other medicines, especially any of the following: Potassium-sparing diuretics (eg, spironolactone) because the risk of high blood potassium levels may be increased; Cyclosporine or other medicines that may harm the kidney (eg, aminoglycoside antibiotics [eg, gentamicin], amphotericin B, cyclosporine, nonsteroidal anti-inflammatory drugs [NSAIDs] [eg, ibuprofen], vancomycin) or the liver (eg, acetaminophen, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection) because the risk of kidney or liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the kidney or liver Many prescription and nonprescription medicines (eg, used for infections, inflammation, aches and pains, high blood pressure, high cholesterol, seizures, stomach problems), multivitamin products, herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort), astemizole, cisapride, dofetilide, ibutilide,sirolimus, terfenadine, and ziprasidone may interact with Tacrolimus, increasing the risk of side effects. This may not be a complete list of all interactions that may occur. Ask your health care provider if Tacrolimus may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Missed dose

If you miss a dose of Tacrolimus, contact your doctor right away.

Storage

Store Tacrolimus at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Tacrolimus out of the reach of children and away from pets.