Notice: Images are for illustration only and may not reflect the exact product you receive. Brand-name medications may look different depending on their country of origin—Canadian versions, for example, often include a "PR" symbol on the packaging. Rest assured, the medication, dosage, and active ingredients will be exactly as prescribed. Canada Pharmacy Store is committed to your health and safety, and we work only with licensed pharmacies to ensure you receive trusted, high-quality medication every time.
Tacrolimus (Generic)
| Advagraf Tacrolimus | ||||||
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Shipped from Canada | ||||||
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| Envarsus XR Tacrolimus | ||||||
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Shipped from Canada | ||||||
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| Prograf Tacrolimus | ||||||
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Shipped from Canada | ||||||
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Who is the product for? YouOtherAdd Family Member/PetYou must be logged in to add additional members to the order. Don't have an account? or Add Family Member/PetSign inTo continue, please enter your email address and password that you use for your account. | ||||||
| Select product strength & quantity:
Who is the product for? YouOtherAdd Family Member/PetYou must be logged in to add additional members to the order. Don't have an account? or Add Family Member/PetSign inTo continue, please enter your email address and password that you use for your account. | ||||||
General Medication Fact Sheet for Tacrolimus
| Field | Information |
|---|---|
| Generic Name | Tacrolimus |
| Brand Name Versions | Prograf, Astagraf XL, Envarsus XR |
| Boxed/Label Warning | Increased risk of serious infections and malignancies (lymphoma and skin cancer). |
| Purpose | Immunosuppressant used to prevent organ rejection after transplantation. Also used to treat atopic dermatitis (eczema). |
| Mechanism of Action | Inhibits T-lymphocyte activation by binding to an intracellular protein (FKBP12) and inhibiting calcineurin. |
| Dosage Forms | Oral capsules, extended-release capsules, oral granules, intravenous solution |
| Available Strengths | Capsules: 0.5 mg, 1 mg, 5 mg; Extended-release capsules: 0.5 mg, 1 mg, 3 mg, 5 mg |
| Dosage Frequency | Usually twice daily (Prograf) or once daily (Astagraf XL, Envarsus XR), depending on the formulation. |
| Common Side Effects | Tremor, headache, diarrhea, nausea, high blood pressure, kidney problems. |
| Serious Side Effects | Infections, lymphoma, skin cancer, kidney damage, seizures, high blood sugar, nerve damage. |
| Drug Interactions | Many drugs can interact with tacrolimus, including antifungals (e.g., ketoconazole), antibiotics (e.g., erythromycin), calcium channel blockers (e.g., verapamil), and grapefruit juice. |
| Important Notes | Regular blood tests are required to monitor tacrolimus levels and kidney function. Avoid grapefruit and grapefruit juice. Protect skin from sun exposure due to increased risk of skin cancer. |
| Storage | Store at room temperature away from moisture and light. |
| Missed Dose | Take as soon as you remember, unless it is almost time for your next dose. Do not double the dose. Consult your doctor for specific instructions. |
| Alternatives | Cyclosporine, Sirolimus, Mycophenolate Mofetil, Azathioprine |
Tacrolimus Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| Cyclosporine (Neoral, Gengraf, Sandimmune) | Inhibits T-lymphocyte activation by binding to cyclophilin and inhibiting calcineurin. | Similar mechanism to tacrolimus, but may have different side effect profiles. |
| Sirolimus (Rapamune) | Inhibits T-lymphocyte proliferation by binding to FKBP12 and inhibiting mTOR. | Works on a different pathway than tacrolimus and Cyclosporine. |
| Mycophenolate Mofetil (CellCept) | Inhibits purine synthesis, suppressing T- and B-lymphocyte proliferation. | Often used in combination with tacrolimus or Cyclosporine. |
| Azathioprine (Imuran, Azasan) | Inhibits purine synthesis, suppressing T- and B-lymphocyte proliferation. | An older immunosuppressant, less commonly used now. |
Tacrolimus Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Tremor | Infections (bacterial, viral, fungal) |
| Headache | Lymphoma |
| Diarrhea | Skin cancer |
| Nausea | Kidney damage |
| High blood pressure | Seizures |
| Kidney problems | High blood sugar (diabetes) |
| Insomnia | Nerve damage |
Tacrolimus Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| Kidney Transplant | 0.1-0.2 mg/kg/day (Prograf) in two divided doses; adjust based on trough levels | Adjust based on trough levels and clinical response. | Administer consistently with or without food. |
| Liver Transplant | 0.1-0.15 mg/kg/day (Prograf) in two divided doses; adjust based on trough levels | Adjust based on trough levels and clinical response. | Administer consistently with or without food. |
| Heart Transplant | 0.03-0.075 mg/kg/day (Prograf) in two divided doses; adjust based on trough levels | Adjust based on trough levels and clinical response. | Administer consistently with or without food. |
| Atopic Dermatitis (Eczema) – Topical | Apply a thin layer of 0.03% or 0.1% ointment to affected areas twice daily. | Continue application as directed by your healthcare provider. | Do not use on large areas of the body. |
