Tacrolimus is an immunosuppressant used to prevent organ rejection of solid organ transplants and for treatment of a variety of auto-immune diseases e.g for nephrotic syndrome. It can also be used to prevent graft-versus-host disease after haematopoietic stem cell transplant. It can be intended for long term use.
Tacrolimus works by suppressing the immune system to prevent organ rejection and graft-versus-host disease.
Tacrolimus weakens your body’s defence mechanism (immune system) to fight against infection. Therefore, you may be more prone to infections while you are taking tacrolimus. Seek medical attention promptly you have a fever (temperature above 38°C) or feel unwell eg. with flu-like symptoms, sweat and chills.
Some other possible side effects of Tacrolimus include:
There are some potentially serious but rare side effects that may be experienced when you are using Tacrolimus. These include:
Stop using Tacrolimus and inform your doctor immediately if you experience any of the potentially serious side effects.
Inform the doctor if you experience any side effects, so that the necessary monitoring may be conducted. Seek immediate medical attention if side effects are serious and urgent for e.g. severe skin reactions such as skin ulcers or allergic reactions such as itchy rash, blistered, peeling skin, swelling in face/ lips/ tongue/ throat, tightness in chest or throat and/ or trouble breathing.
Do not give your child or yourself any other medications or herbal products without consulting your doctor or pharmacist. Some medication or food may reduce its efficacy, or increase the incidence of side effects where close monitoring is required. These include:
1. Grapefruit or pomelo, St John’s wort, alcohol
2. Live vaccines such as BCG, MMR, chickenpox vaccine and some forms of polio or influenza vaccines.
3. Certain antibiotics and antifungals
4. NSAIDs eg. ibuprofen
It is important that you take this medication exactly as prescribed by the doctor. Your doctor may change the dosage of tacrolimus depending on blood tests results. Always follow the doctor’s instructions strictly. Do not stop taking tacrolimus unless you are told to do so by your doctor. Do not take more or less than required unless instructed
Tacrolimus is usually given twice daily and should be given at the same time each day. It should be taken on an empty stomach or at least 1 hour before or 2 hours after a meal, to achieve maximal absorption. Take with food only if you experience stomach upset after taking Tacrolimus. It is advisable to be consistent with the timing and composition of meals if taken with food.
Shake well before taking the medication. Do not administer the suspension once passed the expiry date stated on the bottle.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for the next dose. Do not double dose to make up for the missed dose.
Take precautions to avoid exposure: wear gloves and mask when handling Tacrolimus. Please refer to Patient's Information Leaflet on "Safe Handling of Oral Cytotoxic or Caution Medications" for details.
Compliance to follow up visits
While taking Tacrolimus, you should be seeing your specialist doctor regularly to ensure that your treatment is optimized and to address any concerns relating to your treatment. Regular laboratory tests may be conducted as directed by your doctor to monitor your condition and treatment progress.
Supply of Drugs You are advised not to purchase more Tacrolimus than required before your next visit in case of dose changes or discontinuation of therapy. Do not switch brands without consulting your doctor or pharmacist. Caregiver advice Do not give Tacrolimus to anyone else. It has been prescribed for a specific condition, and may not be the correct treatment for another person, and would be dangerous if the other person is pregnant or breastfeeding.
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