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Tacrolimus ( tak-roh-LEE-muss ) (FK-506, Prograf®, Astagraf XL®, Envarsus XR®) What is this medication used for? Tacrolimus is an immunosuppressant that helps prevent or treat graft versus host disease (GVHD). It works by suppressing the immune system to prevent the white blood cells from damaging or eliminating the transplanted cells.
• Call your healthcare provider if this medicine cannot be taken because of vomiting or diarrhea. • Call your healthcare provider if a fever, bruising, or bleeding develops while this medicine is being taken. • This medication may cause a skin sensitivity to light. Exposure to sunlight and artificial light sources should be avoided. Take precautions when in the sun, and wear protective clothing, sunglasses, and sunscreen with a sun protection factor (SPF) higher than 15. • Grapefruit may increase the concentration of tacrolimus in the blood. Avoid drinking grapefruit juice or eating grapefruit while taking this medication. • Tacrolimus should be taken on an empty stomach at least 1 hour before eating and at least2 hours after eating. • If you miss a dose, give the missed dose unless you are within 6 hours of your next dose. If the missed dose isn’t realized until 6 or fewer hours of the next dose, skip the missed dose (do not double dose) and go back to the regular dosage schedule. If you are not sure about the timing, call the healthcare provider for instructions. • Swallow capsules whole. Do not cut, crush, or chew capsule. • Capsules should be stored at room temperature. • Liquid should be stored at room temperature away from heat and moisture, and the bottle should be shaken well before each use. Throw away any remaining liquid on the expiration date on the bottle.. • Plan ahead so that you do not run out of medication. • Do not take antacids (such as Tums® or Mylanta®) 2 hours before or after taking tacrolimus.
What does it look like? • Capsule • Granule • Liquid How is it given? • By mouth (oral or po)
• Into the vein (IV) or venous access device What are the common side effects? • High blood pressure (hypertension) • Loss of magnesium in the blood • Constipation or diarrhea • Nausea and vomiting • Headache • Problems sleeping (insomnia) • Increased risk of infection • Shaking (tremor) • Kidney damage • Skin sensitivity to light What are the less common side effects? • Increased potassium in the blood • High blood sugar (hyperglycemia) • Numbness and tingling (peripheral neuropathy) • Changes in liver function tests • Severe allergic reaction (anaphylaxis) • Seizures Special instructions:
• A blood test may be done to check the level of medicine in the blood. Do not take this medicine in the morning before coming to the clinic. Bring the medicine with you and take it after the blood test has been completed.
Notes from Your Healthcare Team
Not all of the possible side effects of this medicine and precautions related to taking it are covered in this information sheet. For a complete list of side effects and precautions, ask your healthcare professional (doctor, nurse, pharmacist) for a manufacturer’s package insert or another reference.
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