Is tacrolimus a high risk drug?
Tacrolimus is a very strong medicine. It can cause side effects that can be very serious, such as kidney problems. It may also decrease the body's ability to fight infections. You and your doctor should talk about the benefits of this medicine as well as the risks of using it.
Avoid grapefruit juice while taking Tacrolimus. Grapefruit and Grapefruit juice increase Tacrolimus blood levels significantly leading to side effects like abdominal pain, confusion, decreased urination, dizziness, headache, mood changes, nausea-vomiting, tremor, yellowing of skin or eyes, weakness, or other problems.
Tacrolimus ointment is intended to be used for a short period of time (up to six weeks). It should not be used every day over a long period of time. Some people who frequently have flares may be prescribed the ointment to use on two days of each week to prevent further flares from developing.
Some of the most commonly reported side effects include hypertension, diarrhea, hyperglycemia, anemia, headache, tremor, insomnia, pain, and asthenia.
For tacrolimus, 19 cases of cancer were reported, involving 16 adults and 3 children under the age of 16. The cancers were diagnosed 21–790 days after the start of therapy. Nine cases involved lymphomas, and 10 involved skin tumours. The majority of the skin tumours occurred at the site of the drug application.
Usually tacrolimus is taken twice a day, 12 hours apart, such as at 8 a.m. and 8 p.m. Occasionally it is taken only once a day (usually in the morning and at the same time each day) or as often as three times a day (8 hours apart, such as at 7 a.m., 3 p.m., and 11 p.m.). Tacrolimus can be taken with or without food.
Stopping these medications, however, may lead to acute rejection within days to weeks of roughly one quarter to one-half of SOT patients (4,5). For many of these patients, the signs and symptoms of acute rejection closely resemble the dying process and include delirium, pain, fever, and malaise.
Furthermore, tacrolimus treatment is associated with impaired cognitive function in the long-term in patients after liver transplantation. We hypothesize that long-term tacrolimus therapy is associated with cognitive dysfunction and alterations of brain structure and metabolism in patients after kidney transplantation.
Interactions between your drugs
No interactions were found between caffeine and tacrolimus.
No interactions were found between tacrolimus and Vitamin D3. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Is tacrolimus a strong steroid?
No, tacrolimus (Protopic) is not a steroid. Instead, it belongs to a class of medications called calcineurin inhibitors. Topical calcineurin inhibitors work by blocking calcineurin, a protein in our bodies that helps activate our immune system.
You might have to take this medicine for the rest of your life to prevent your body from rejecting the transplant. Use only the brand of this medicine that your doctor prescribed.
Effectiveness of tacrolimus was maintained with prolonged daily use. Tacrolimus ointment (0.1%) is safe and effective for long-term treatment of atopic dermatitis in children.
Conclusion: Tacrolimus appears to be associated with alopecia totalis in patients who have received a kidney and/or pancreas transplant and the increased risk for hair loss seems to be dose related.
Does tacrolimus interact with any foods or beverages? Avoid excessive intake of high potassium foods (bananas, oranges, orange juice, potatoes, spinach, etc). Do not eat grapefruits, grapefruit juice or any soda (Fresca) or fruit juice blend that contains grapefruit juice.
Our case suggests that white matter damage caused by tacrolimus can have a slow onset and be seen years after its initiation and manifest as dementia. Follow-up in transplanted patients should include regular neurologic assessment since symptoms seem to be reversible after discontinuation of the drug.
Cardiac toxicity, a rare serious adverse effect of Tacrolimus has been observed in patients receiving solid organ transplant such as liver, bowel and kidney. In this report, we describe a case of new onset severe dilated cardiomyopathy after kidney transplantation.
It is important that this medication is given only as directed, and not given to other people. Tacrolimus should be given about the same time each day to keep a constant level in the blood. It should be taken about 12 hours apart and at least one hour before food, in two equal doses.
Tacrolimus works slowly and may take up to 12 weeks to take effect. Unless you have severe side effects it is important to continue taking it even if you do not notice any change in your symptoms.
In addition to sequelae related to immunosuppression, tacrolimus can have serious ophthalmic adverse effects. It has been reported in association with tear deficiency, eyelash trichomegaly, conjunctival intraepithelial neoplasia, CMV (cytomegalovirus) retinitis, cortical blindness, and maculopathy.
What class of medication is tacrolimus?
Tacrolimus is in a class of medications called immunosupressants. It works by decreasing the activity of the immune system to prevent it from attacking the transplanted organ.
Children younger than 2 years of age—Use is not recommended.
Most individuals display optimal response to tacrolimus with trough whole blood levels of 5.0 to 15.0 ng/mL. Preferred therapeutic ranges may vary by transplant type, protocol, and comedications. Therapeutic ranges are based on specimen collected at trough (ie, immediately before a scheduled dose).
Tacrolimus, cyclosporine, and methotrexate are standard of care drugs given after transplant to help prevent GVHD. Tacrolimus and cyclosporine are in a class of medications called immunosupressants. They work by decreasing the activity of the immune system to prevent it from attacking the transplant.
Stopping these medications, however, may lead to acute rejection within days to weeks of roughly one quarter to one-half of SOT patients (4,5). For many of these patients, the signs and symptoms of acute rejection closely resemble the dying process and include delirium, pain, fever, and malaise.
Pimecrolimus has fewer side effects than topical steroids and a better side-effect profile than tacrolimus.
Tacrolimus (TAC) is a widely used maintenance immunosuppressant, but its long-term use causes considerable nephrotoxicity. TAC causes irreversible kidney injury with arteriolar hyalinization and thickening, vasoconstriction and ischemia, tubulointerstitial fibrosis, apoptosis, and atrophy [1, 2].
On the other hand, high doses of tacrolimus significantly increased serum creatinine levels when compared with the control group and the SHAM group but lower doses did not cause significant changes.
Tacrolimus frequently induces neurological complications in the first few weeks after transplantation. Furthermore, tacrolimus treatment is associated with impaired cognitive function in the long-term in patients after liver transplantation.
Conclusion: Tacrolimus appears to be associated with alopecia totalis in patients who have received a kidney and/or pancreas transplant and the increased risk for hair loss seems to be dose related.
Is tacrolimus cancerous?
Discussion: The data demonstrated that patients treated with tacrolimus had a higher risk of carcinogenicity compared to patients treated with SRL. However, patients treated with tacrolimus had a similar incidence of carcinogenicity compared to patients treated with CsA.
