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In this Article

• What is tacrolimus (Prograf)?
• What are the possible side effects of tacrolimus (Prograf)?
• What is the most important information I should know about tacrolimus (Prograf)?
• What should I discuss with my healthcare provider before taking tacrolimus (Prograf)?
• How should I take tacrolimus (Prograf)?
• What happens if I miss a dose (Prograf)?
• What happens if I overdose (Prograf)?
• What should I avoid while taking tacrolimus (Prograf)?
• What other drugs will affect tacrolimus (Prograf)?
• Where can I get more information?

What happens if I miss a dose (Prograf)?

Take the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Prograf)?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a tacrolimus overdose are unknown.

What should I avoid while taking tacrolimus (Prograf)?

Avoid contact with people who have colds, the flu, or other contagious illnesses. Contact your doctor immediately if you develop signs of infection.

Do not consume grapefruit or grapefruit juice during treatment with tacrolimus unless your doctor has told you do. Tacrolimus can have a dangerous interaction with grapefruit or grapefruit juice.

Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Tacrolimus may increase the risk of skin cancer. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Do not receive a "live" vaccine while you are being treated with tacrolimus. Vaccines may not work as well during your treatment with tacrolimus.

What other drugs will affect tacrolimus (Prograf)?

Tacrolimus can be harmful to the kidneys, and this effect is increased when tacrolimus is used together with other medicines that can harm the kidneys. Before taking tacrolimus, tell your doctor if you are receiving chemotherapy, or using medicines to treat a bowel disorder, antiviral medications, pain or arthritis medicines, any injected antibiotics, or other medications to prevent organ transplant rejection. You may need dose adjustments or special tests when taking any of these medications together with tacrolimus.

Many drugs can interact with tacrolimus. Below is just a partial list. Tell your doctor if you are using:

• birth control pills or hormone replacement;
• metoclopramide (Reglan);
• mycophenolate mofetil (CellCept);
• sirolimus (Rapamune);
• St John's wort;
• lansoprazole (Prevacid), omeprazole (Prilosec, Zegrid)
• rifampin (Rifadin, Rimactane, Rifater) or rifabutin (Mycobutin);
• a potassium supplement or a diuretic (water pill);
• a calcium channel blocker such as verapamil (Calan, Verelan), diltiazem (Cardizem, Dilacor XR, Tiazac), nifedipine (Adalat, Procardia), or nicardipine (Cardene);
• antifungal medicines such as ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan), caspofungin (Cancidas), clotrimazole (Mycelex Troche), voriconazole (VFEND);
• erythromycin (Ery-Tab, E-Mycin, E.E.S.), clarithromycin (Biaxin), or troleandomycin (TAO);
• HIV medicines such as lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), or ritonavir (Norvir);
• an antacid containing magnesium or aluminum such as Rulox, Amphojel, Milk of Magnesia; or
• seizure medicine such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Luminal), phenytoin (Dilantin).

This list is not complete and there are many other medicines that can interact with tacrolimus. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about tacrolimus.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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