Tacrolimus: functions, dosage, side effects, how to use it

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What is the drug Tacrolimus?

What is Tacrolimus for?

Tacrolimus is a drug that is commonly used with other drugs to prevent rejection of a kidney, heart, or liver transplant. This injectable form of medicine is used when you are unable to take the medicine. The doctor will change it to a form that can be taken orally as soon as possible. This drug belongs to the immunosuppressant class. These drugs work by weakening the body's defense system (immune system) to help the body accept new organs like its own.

OTHER USES: This section contains medicinal uses not stated on the professionally approved label but may be prescribed by your doctor. Use this medication for the conditions mentioned in this section only when prescribed by your doctor.

It is also used to treat certain types of digestive disorders (severe Chron fulminant disease) in patients who have not been successfully treated with regular therapy. This medication is also used to prevent transplant rejection of other organs (such as lungs).

How to use Tacrolimus?

This drug is injected into a vein by a health care provider.

The dose of this medication is based on your body weight, health condition, blood tests (such as tacrolimus levels), and your response to therapy.

Tell your doctor if your condition worsens.

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

How to store Tacrolimus?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Tacrolimus dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dose of Tacrolimus for adults?

KIDNEY TRANSPLANTATION:

IMMEDIATE RELEASE:

• combination with azathioprine: Initial dose: 0.1 mg / kg orally every 12 hours. Start within 24 hours of surgery, but delay until kidney function improves.
• combination with mycophenolatemofetil (MMF) / interleukin-2 (IL-2) receptor antagonist: Initial dose: 0.05 mg / kg orally every 12 hours. Start within 24 hours of surgery, but delay until kidney function improves.

EXTENDED RELEASE:

• with Basiliximab Induction, MMF, and Corticosteroids: Initial dose: 0.15 mg / kg / day orally in a single dose. Start the first dose before or within 48 hours of transplantation. Postpone until kidney function improves.
• with MMF and Corticosteroids, but without induction of Basiliximab: Pre-operative dose: 0.1 mg / kg / day orally in a single dose within 12 hours before reperfusion;
• Post-operative dose: 0.2 mg / kg / day orally in a single dose. Give the first postoperative dose within 12 hours after reperfusion but not less than 4 hours after the preoperative dose.

INTRAVENES:

-The initial dose: 0.03-0.05 mg / kg / day in continuous IV infusion

Adult Dose for Graft Versus Host Disease:

Some experts recommend:

Prevention:

• Intravenous Injection: Initial dose: 0.03 mg / kg / day (based on dry body weight) in continuous infusion. Start at least 24 hours before the stem cell infusion and continue only until the oral medication is tolerated.

Therapy:

• Intravenous Injection: Initial dose: 0.03 mg / kg / day (based on dry body weight) in continuous infusion.

What is the dosage of Tacrolimus for children?

Child Dose for Organ Transplantation - Rejection Prophylaxis:

HEART TRANSPLANTATION:

IMMEDIATE RELEASE:

-The initial dose: 0.075-0.1 mg / kg orally every 12 hours

INTRAVENES:

-The initial dose: 0.03-0.05 mg / kg / day in continuous IV infusion

Child Dose for Graft Versus Host Disease:

Some experts recommend:

Prevention:

- Intravenous injection: Initial dose: 0.03 mg / kg / day (based on dry body weight) in continuous infusion. Start at least 24 hours before the stem cell infusion and continue only until the oral medication is tolerated.

In what dosage is Tacrolimus available?

Tacrolimus is available in the following dosages.

0.5 mg capsule; 1 mg; 5 mg

Solution 5 mg / mL

Tacrolimus side effects

What side effects can be experienced due to Tacrolimus?

Seek immediate medical help if you experience any of the following signs of an allergic reaction: hives, difficulty breathing, swelling of the face, lips, tongue, or throat.

Call your doctor if you have serious side effects such as:

• Fever, chills, body aches, flu symptoms, canker sores in the mouth and throat
• Changes in mental status, trouble speaking or walking, decreased vision (can start slowly and get worse quickly)
• Pale or yellowing skin, dark urine, confusion or weakness
• Feeling like floating or short of breath, fast heart rate, difficulty concentrating
• Back or lumbago, bloody urine, pain or burning sensation when urinating
• Urinating less or not urinating
• Dry cough, cough with phlegm or blood, sweating, wheezing, shortness of breath, chest pain
• tremors (shaking), seizures (convulsions)
• high potassium levels (slow heart rate, weak pulse, muscle weakness, tingling feeling)
• low magnesium levels (jerky muscles, muscle weakness, slow reflexes)
• high blood pressure (severe headache, blurred vision, ringing in the ears, anxiety, chest pain, shortness of breath, irregular heartbeat)
• high blood sugar (frequent thirst, frequent urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss)

The less severe side effects include:

• nausea, abdominal pain, diarrhea, constipation
• headache
• sleep disorders (insomnia)
• swollen hands or feet

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Tacrolimus Drug Warnings and Cautions

What should be known before using Tacrolimus?

In using this drug, the risks of using the drug must be weighed against the benefits obtained. The decision is made by the doctor and you. For this drug, the following should be considered:

Allergy

Tell your doctor if you have had an allergic reaction to this or any other medicine. And also let me know if you have allergies to anything else, such as food, coloring, preservatives, or animals. For non-prescription products, read the ingredients in the packaging carefully.

Children

Research has not demonstrated specific pediatric problems, so the benefits of tacrolimus are still limited to children with liver transplants.

Research has not shown a link between age and the effects of tacrolimus in children with kidney and heart transplants. Its safety and efficacy are unknown.

Elderly

Research has not pinpointed specific elderly problems, so the benefits are still limited to the elderly.

Even so, elderly patients are more prone to developing liver, kidney or heart problems due to age, which may require an adjustment in the dose in patients receiving tacrolimus.

Is Tacrolimus safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = No risk,
• B = not at risk in several studies,
• C = May be risky,
• D = There is positive evidence of risk,
• X = Contraindicated,
• N = Unknown

Tacrolimus Drug Interactions

What medicines may interact with Tacrolimus?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Although certain drugs cannot be used together, in other cases 2 different drugs can be used simultaneously although drug interactions may occur. In this case, the doctor can change the dose, or other warnings may be needed. Tell your doctor if you are taking any other prescription or nonprescription drugs.

Using this medicine with any of the following medicines is not recommended, your doctor may not treat you with this medicine or change the medicine you are taking.

• Amifampridine
• Dronedarone
• Fluconazole
• Mifepristone
• Nelfinavir
• Pimozide
• Piperaquine
• Posaconazole
• Ziprasidone

Using this medication with the following drugs is usually not recommended, but may be needed in some cases. If the two drugs are prescribed together, your doctor may have changed the dose or frequency of use of one or both drugs.

• Aceclofenac
• Acemetacin
• Adalimumab
• Afatinib
• Alefacept
• Amikacin
• Amiloride
• Amiodarone
• AmtolmetinGuacil
• Anagrelide
• Aripiprazole
• Artemether
• Aspirin
• Atazanavir
• Bacillus of Calmette and Guerin Vaccine, Live
• Basiliximab
• Bedaquiline
• Blinatumomab
• Bromfenac
• Bufexamac
• Buserelin
• Carbamazepine
• Caspofungin
• Celecoxib
• Ceritinib
• Choline Salicylate
• Cisplatin
• Citalopram
• Clarithromycin
• Clonixin
• Clozapine
• Colchicine
• Crizotinib
• Cyclosporine
• Dabrafenib
• Darunavir
• Delamanid
• Deslorelin
• Dexibuprofen
• Dexketoprofen
• Dibekacin
• Diclofenac
• Dislunisal
• Dipyrone
• Domperidone
• Efavirenz
• Eliglustat
• Enzalutamide
• Erythromycin
• Escitalopram
• Eslicarbazepine Acetate
• Esomeprazole
• Etodolac
• Etofenamate
• Etoricoxib
• Etravirine
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Fluoxetine
• Flurbiprofen
• Foscarnet
• Fosphenytoin
• Gentamicin
• Gonadorelin
• Goserelin
• Haloperidol
• Histrelin
• Ibuprofen
• Ibuprofen Lysine
• Idelalisib
• Iloperidone
• Indomethacin
• Infliximab
• Itraconazole
• Ivabradine
• Kanamycin
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lapatinib
• Leuprolide
• Lornoxicam
• Loxoprofen
• Lumefantrine
• Lumiracoxib
• Measles Virus Vaccine, Live
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Metronidazole
• Mitotane
• Morniflumate
• Moxifloxacin
• Mumps Virus Vaccine, Live
• Nabumetone
• Nafarelin
• Naproxen
• Nefazodone
• Neomycin
• Nepafenac
• Netilmicin
• Niflumic Acid
• Nilotinib
• Nimesulide
• Omeprazole
• Ondansetron
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Pasireotide
• Pazopanib
• Phenobarbital
• Phenylbutazone
• Phenytoin
• Piketoprofen
• Piroxicam
• Pixantrone
• Poliovirus Vaccine, Live
• Pranoprofen
• Primidone
• Proglumetacin
• Propyphenazone
• Proquazone
• Quetiapine
• Ranolazine
• Rifabutin
• Rifampin
• Rofecoxib
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Salicylic Acid
• Salsalate
• Sevoflurane
• Siltuximab
• Sirolimus
• Vaccine Smallpox
• Sodium Salicylate
• Spironolactone
• St. John's Wort
• Streptomycin
• Sulindac
• Sunitinib
• Telaprevir
• Telithromycin
• Tenofovir
• Tenoxicam
• Tiaprofenic Acid
• Ticagrelor
• Tizanidine
• Tobramycin
• Tocophersolan
• Tolfenamic Acid
• Tolmetin
• Triamterene
• Triptorelin
• Typhoid Vaccine
• Ulipristal
• Valdecoxib
• Vandetanib
• Varicella Virus Vaccine
• Vemurafenib
• Vilanterol
• Vinflunine
• Voriconazole
• Yellow Fever Vaccine

The interactions with the drugs below can increase the risk of serious side effects, but using both drugs may be the best therapy for you. If the two drugs are prescribed together, your doctor may have changed the dose or frequency of use of one or both drugs.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Amprenavir
• Boceprevir
• Chloramphenicol
• Clotrimazole
• Dalfopristin
• Danazol
• DihydroxyaluminumAminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Diltiazem
• Ertapenem
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate
• Metoclopramide
• Mibefradil
• Nevirapine
• Nifedipine
• Quinupristin
• Rifapentine
• Ritonavir
• Saquinavir
• Schisandrasphenanthera
• Theophylline
• Tigecycline

Can food or alcohol interact with Tacrolimus?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

The following interactions were selected based on differences in drug potential and not necessarily all included.

Using this drug with other drugs is usually not recommended, but may be needed in some cases. If the two drugs are prescribed together, your doctor may have changed the dose or frequency of one or both drugs, or given you certain warnings about using food, alcohol, or smoking.

• • Ethanol

• Grapefruit juice

What health conditions may interact with Tacrolimus?

The presence of other health problems in your body may affect the use of this drug. Tell your doctor if you have other health problems, in particular:

• Congestive heart failure
• Diabetes
• Heart disease
• Heart rhythm disturbances (eg prolonged QT), or family history
• Hyperkalemia (high potassium level in the blood) or
• Hypertension (high blood pressure)
• History of myocardial hypertrophy (heart larger than normal)
• History of paresthesia (numbness or tingling in the hands, arms, legs)
• History of seizures (convulsions)
• Tremors - use with care. May worsen the condition
• Active infection (for example, bacterial, fungal, or viral) - can decrease your body's ability to fight infection
• Kidney illness
• Liver disease - Use with caution. The effect can be increased due to slower removal of the drug from the body

Tacrolimus overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Symptoms of an overdose include:

• Itchy rash
• sleepy

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.