Tacrolimus (Injection)

Introduction

Tacrolimus (ta-KROE-li-mus)

Keeps your body from rejecting an organ transplant such as a kidney, liver, or heart. This medicine may be used with steroids, azathioprine, or mycophenolate mofetil.

Brand Name(s)

There may be other brand names for this medicine.

Prograf

When This Medicine Should Not Be Used

You should not receive this medicine if you have had an allergic reaction to tacrolimus or castor oil.

How to Use This Medicine

Injectable

  • Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given through a needle placed in one of your veins.
  • A nurse or other trained health professional will give you this medicine. You will be watched closely for about 30 minutes after you start to receive this medicine, especially if you are getting it for the first time.
  • The needle will have to remain in place while you are receiving this medicine.
  • You will continue to receive this medicine until you are able to take the oral (by mouth) form of tacrolimus.

If a dose is missed:

  • Call your doctor or pharmacist for instructions.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • There are many other drugs that can interact with tacrolimus. Make sure your doctor knows about all other medicines you are using.
  • Make sure your doctor knows if you are using cisplatin (Platinol®-AQ) or cyclosporine (Gengraf®, Neoral®, or Sandimmune®). Tell your doctor if you are also using medicine for high blood pressure (such as diltiazem, nicardipine, nifedipine, verapamil, Calan®, Cardene®, Cartia®, or Procardia®) or stomach problems (such as antacids, cimetidine, lansoprazole, metoclopramide, omeprazole, Mylanta®, Prevacid®, Prilosec®, Reglan®, or Tagamet®).
  • Make sure your doctor knows if you are using bromocriptine (Parlodel®), danazol (Danocrine®), ethinyl estradiol (Estinyl®), methylprednisolone (Medrol®), nefazodone (Serzone®), St. John's wort, or sirolimus (Rapamune®). Your doctor should also know if you are using medicines to treat seizures (such as carbamazepine, phenobarbital, phenytoin, Carbatrol®, Dilantin®, or Luminal®), bacteria infections (such as amikacin, chloramphenicol, clarithromycin, erythromycin, gentamicin, rifabutin, rifampin, streptomycin, troleandomycin, Amikin®, Biaxin®, Ery-Tab®, Garamycin®, Mycobutin®, Rifadin®, or Tao®), virus infections (such as ganciclovir, nelfinavir, ritonavir, Cytovene®, Norvir®, or Viracept®), or fungus infections (such as amphotericin B, caspofungin, clotrimazole, fluconazole, itraconazole, ketoconazole, voriconazole, Amphocin®, Cancidas®, Clotrim®, Diflucan®, Nizoral®, Sporanox®, or Vfend®).
  • Tell your doctor if you are using diuretics or ("water pills") such as spironolactone, triamterene, or Aldactone®.
  • Talk to your doctor before getting flu shots or other vaccines while you are receiving this medicine. Vaccines may not work as well, or they could make you ill while you are using this medicine.
  • Do not eat grapefruit or drink grapefruit juice while you are using this medicine.

Warnings While Using This Medicine

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, high blood pressure, cancer, diabetes, high potassium in the blood, brain or nerve problems, or any infection.
  • Your doctor will need to check your blood or urine at regular visits while you are using this medicine. Be sure to keep all appointments.
  • This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have itching; hives; hoarseness; shortness of breath; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you receive this medicine.
  • This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
  • This medicine may increase your risk of developing tumors or skin cancer. Talk with your doctor if you have concerns.
  • Some people who have had transplants and used tacrolimus have developed diabetes. This has happened more often in people who are Hispanic or African-American and have had a kidney transplant. You may also have a higher risk of skin cancer or cancer of the lymph system while using tacrolimus. Talk to your doctor if you have concerns about these risks.
  • This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
  • Blistering, peeling, or red skin rash.
  • Change in how much or how often you urinate, or painful urination.
  • Chest pain, shortness of breath, cold sweat, and bluish-colored skin.
  • Confusion, weakness, uneven heartbeat, or numbness or tingling in your hands, feet, or lips.
  • Dark-colored urine or pale stools.
  • Dry mouth, muscle cramps, nausea, or vomiting.
  • Fast, slow, or pounding heartbeat.
  • Fever, chills, cough, sore throat, and body aches.
  • Gaining weight around your neck, upper back, breast, face, or waist.
  • Increased thirst or hunger.
  • Lightheadedness, dizziness, or fainting.
  • Numbness or weakness in your arm or leg, or on one side of your body.
  • Problems with hearing, vision, speech, balance, or walking.
  • Rapid weight gain.
  • Seeing or hearing things that are not really there.
  • Seizures, tremors, or muscle twitching.
  • Sudden and severe stomach pain.
  • Swelling in your hands, ankles, or feet.
  • Trouble breathing or swallowing.
  • Unusual bleeding, bruising, or weakness.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Agitation, depression, nervousness, or mood changes.
  • Diarrhea, constipation, loss of appetite, or upset stomach.
  • Hair loss, or increased body hair.
  • Headache.
  • Joint pain or back pain.
  • Pain, itching, burning, swelling, or a lump under your skin where the needle is placed.
  • Sores or white patches on your lips, mouth, or throat.
  • Trouble sleeping.
  • Warmth or redness in your face, neck, arms, or upper chest.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Review Date: 2011-02-04 Reviewed By: Keywords: ,
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