"By Megan Brooks
Medscape Medical News
The European Medicines Agency (EMA) Committee for Medicinal Products for Human Use (CHMP) has recommended approval of tolvaptan (Jinarc, Otuska) to slow progression of cyst developmen"...
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(tacrolimus) extended-release capsules
What is the most important information I should know about ASTAGRAF XL?
ASTAGRAF XL can cause serious side effects, including:
- Increased risk of cancer. People who take ASTAGRAF XL have an increased risk of getting some kinds of cancer, including skin and lymph gland cancer (lymphoma).
- Increased risk of infection. ASTAGRAF XL is a
medicine that affects your immune system. ASTAGRAF XL can lower the ability of
your immune system to fight infections. Serious infections can happen in people
receiving ASTAGRAF XL that can cause death. Call your doctor right away if
you have symptoms of an infection such as:
- sweats or chills
- cough or flu-like symptoms
- muscle aches
- warm, red, or painful areas on your skin
- Increased risk of death in females who have had a liver transplant. You should not take ASTAGRAF XL if you have had a liver transplant without talking to your doctor.
What is ASTAGRAF XL?
- ASTAGRAF XL is a prescription medicine used with other medicines to help prevent organ rejection in people who have had a kidney transplant.
- ASTAGRAF XL is an extended-release capsule and is not the same as tacrolimus immediate-release capsules. Your doctor should decide what medicine is right for you.
Who should not take ASTAGRAF XL?
- Do not take ASTAGRAF XL if you are allergic to tacrolimus or any of the ingredients in ASTAGRAF XL. See the end of this leaflet for a complete list of ingredients in ASTAGRAF XL.
Before you take ASTAGRAF XL tell your doctor if you:
- plan to receive any live vaccines. Ask your doctor if you are not sure if your vaccine is a live vaccine.
- have or have had liver, kidney, or heart problems or any other medical conditions.
- are pregnant or plan to become pregnant. ASTAGRAF XL may harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.
- are breastfeeding or plan to breastfeed. ASTAGRAF XL can pass into your breast milk. You and your doctor should decide if you will take ASTAGRAF XL or breastfeed. You should not do both.
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
How should I take ASTAGRAF XL?
- Take ASTAGRAF XL exactly as your doctor tells you to take it.
- Your doctor may change your dose if needed. Do not stop taking or change your dose of ASTAGRAF XL without talking to your doctor.
- Take ASTAGRAF XL capsules whole. Do not break, crush, chew, or dissolve ASTAGRAF XL capsules before swallowing. If you cannot swallow ASTAGRAF XL capsules whole, tell your doctor.
- Take ASTAGRAF XL at the same time each morning, preferably on an empty stomach at least 1 hour before, or at least 2 hours after, you have eaten a meal.
- If you miss your dose of ASTAGRAF XL, it should be taken as soon as possible, but no longer than 14 hours after your regularly scheduled time. If it is longer than 14 hours, the missed dose should be skipped and the next dose should be taken the following morning at your regularly scheduled time. Do not take 2 doses at the same time.
- If you take too much ASTAGRAF XL, call your doctor or go to the nearest hospital emergency room right away.
What should I avoid while taking ASTAGRAF XL?
- Live vaccines such as flu vaccine through your nose, measles, mumps, rubella, polio by mouth, BCG (TB vaccine), yellow fever, chicken pox (varicella) or typhoid.
- Exposure to sunlight and UV light such as tanning machines. Wear protective clothing and use a sunscreen.
- You should not eat grapefruit or drink grapefruit juice while taking ASTAGRAF XL.
- You should not drink alcohol when taking ASTAGRAF XL.
What are the possible side effects of ASTAGRAF XL?
ASTAGRAF XL may cause serious side effects, including:
- See “What is the most important information I should know about ASTAGRAF XL?”
- graft rejection and other serious reactions.
People who take ASTAGRAF XL have sometimes been given the wrong medicine
because some medicines have the same ingredient (tacrolimus) as ASTAGRAF XL.
Serious reactions have happened including graft rejection. Check your
ASTAGRAF XL when you get a new prescription to make sure you have received the
- Call your doctor right away if you think you were given the wrong medicine
- Ask your doctor or pharmacist if you are not sure what ASTAGRAF XL should look like.
- high blood sugar (diabetes). Your doctor may do
certain tests to check for diabetes while you take ASTAGRAF XL. Call your
doctor right away if you have:
- frequent urination
- increased thirst or hunger
- blurred vision
- loss of appetite
- fruity smell on your breath
- nausea, vomiting, or stomach pain
- kidney problems. Your doctor may do certain tests to check your kidney function.
- nervous system problems. Call your doctor or go to
the nearest hospital emergency room right away if you get any of the these
symptoms while taking ASTAGRAF XL. These could be signs of serious nervous
- changes in alertness
- muscle tremors
- numbness and tingling
- vision changes
- high levels of potassium in your blood. Your doctor may do certain tests to check your potassium level while you take ASTAGRAF XL.
- high blood pressure. Your doctor will monitor your blood pressure while you take ASTAGRAF XL.
- changes in the electrical activity of your heart (QT prolongation).
The most common side effects of ASTAGRAF XL are diarrhea, constipation, nausea, swelling of the hands, ankles, or legs, and tremors (shaking of the body).
These are not all the possible side effects of ASTAGRAF XL. For more information, ask your doctor or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How should I store ASTAGRAF XL?
- Store ASTAGRAF XL at room temperature between 68°F to 77°F (20°C to 25°C).
- Safely throw away medicine that is out of date or no longer needed.
- Keep ASTAGRAF XL and all medicines out of reach of children.
General information about the safe and effective use of ASTAGRAF XL.
- This Medication Guide summarizes the most important information about ASTAGRAF XL. If you would like more information, talk to your doctor. You can ask your pharmacist or doctor for information about ASTAGRAF XL that is written for health professionals.
What are the ingredients in ASTAGRAF XL?
Active ingredient: tacrolimus.
- The capsule contains: ethylcellulose NF, hypromellose USP, magnesium stearate NF, and lactose monohydrate NF
- The capsule shell contains: gelatin NF, titanium dioxide USP, ferric oxide NF, and sodium lauryl sulfate
Last reviewed on RxList: 12/28/2015
This monograph has been modified to include the generic and brand name in many instances.
Additional Astagraf XL Information
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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