Generic Name: tacrolimus (oral and injection) (ta KROE li mus)
Brand Names: Astagraf XL, Hecoria, Prograf
What is Prograf?
Prograf (tacrolimus) lowers your body's immune system. The immune system helps your body fight infections. The immune system can also fight or "reject" a transplanted organ such as a liver or kidney. This is because the immune system treats the new organ as an invader.
Prograf is used together with other medicines to prevent your body from rejecting a heart, liver, or kidney transplant.
Prograf may also be used for purposes not listed in this medication guide.
Prograf may increase your risk of developing serious infections, cancer, or transplant failure. Talk with your doctor about the risks and benefits of using this medication.
You will need regular medical tests to be sure Prograf is not causing harmful effects. Do not miss any follow up visits to your doctor for blood or urine tests. Avoid being near people who are sick or have infections.
Prograf can harm your kidneys, and this effect is increased when you also use certain other medicines harmful to the kidneys. Before using Prograf, tell your doctor about all other medicines you use. Many other drugs (including some over-the-counter medicines) can be harmful to the kidneys.
Call your doctor right away if you have symptoms of a serious brain infection, such as a change in your mental state, problems with speech or walking, or decreased vision. These symptoms may start gradually and get worse quickly.
Call your doctor right away if you have any signs of infection, such as fever, chills, body aches, skin warmth or redness, or flu symptoms.
Before taking this medicine
You should not use Prograf if you are allergic to tacrolimus or hydrogenated castor oil, or if you have used cyclosporine (Neoral, Sandimmune, Gengraf) within the past 24 hours.
Prograf can lower blood cells that help your body fight infections, or cause your body to produce too much of a certain type of white blood cell. This can lead to serious and sometimes fatal conditions, including cancer, a severe brain infection that can lead to disability or death, or a virus that can cause failure of a transplanted kidney.
Using Prograf may increase your risk of developing skin cancer, especially if you are treated over long periods of time with drugs that weaken the immune system. Talk with your doctor about your specific risk.
Some people taking Prograf after a kidney transplant have developed diabetes. This effect has been seen most commonly in people who are Hispanic or African-American. Talk with your doctor about your individual risk of diabetes if you have concerns.
To make sure Prograf is safe for you, tell your doctor if you have:
kidney or liver disease;
heart disease, high blood pressure, high cholesterol or triglycerides (a type of fat in the blood);
a heart rhythm disorder or history of long QT syndrome;
if you take heart rhythm medication;
if you use other medicines to prevent rejection of a transplanted organ; or
if you use other medications that can weaken your immune system.
FDA pregnancy category C. It is not known whether Prograf will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
See also: Pregnancy and breastfeeding warnings (in more detail)
Tacrolimus can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Prograf.
How should I take Prograf?
Take Prograf exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
You may receive an injection of Prograf shortly after your transplant. The injection is given until you are ready to take the capsule form.
The Prograf capsule is usually taken every 12 hours. Take the medicine at the same time each day. You may take the capsule with or without food, but take it the same way each time.
Do not crush, chew, break, or open an extended-release capsule. Swallow it whole.
While using Prograf, you may need frequent blood tests. Your blood pressure will need to be checked often.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid?
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Do not receive a "live" vaccine while using Prograf, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Grapefruit and grapefruit juice may interact with Prograf and lead to unwanted side effects. Avoid the use of grapefruit products while taking Prograf.
Avoid exposure to sunlight or tanning beds. Prograf can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Prograf side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Prograf: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
swelling, rapid weight gain, little or no urinating;
chest pain, shortness of breath, feeling like you might pass out;
headache, tremors, numbness and tingly feeling, seizure (convulsions);
bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
high blood pressure--severe headache, blurred vision, buzzing in your ears, anxiety, chest pain, shortness of breath, uneven heartbeats;
high blood sugar--increased thirst, increased urination, hunger, fruity breath odor, nausea, loss of appetite, drowsiness, blurred vision, confusion;
high potassium--slow heart rate, weak pulse, muscle weakness, tingly feeling;
low magnesium or phosphate--bone pain, jerky muscle movements, muscle weakness or limp feeling, slow reflexes;
signs of infection in the brain--change in your mental state, problems with speech or walking, decreased vision (may start gradually and get worse quickly); or
symptoms of a new infection--sudden weakness or ill feeling, fever, chills, sore throat, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing, pale skin, easy bruising, unusual bleeding.
Common Prograf side effects may include:
diarrhea, constipation, stomach pain;
weakness, mild headache;
sleep problems (insomnia); or
swelling in your hands or feet.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Prograf?
Prograf can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).
Many medicines can interact with Prograf and should not be used at the same time. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed in this medication guide. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
More about Prograf (tacrolimus)
Related treatment guides
Where can I get more information?
- Your pharmacist can provide more information about Prograf.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Prograf only for the indication prescribed.
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Copyright 1996-2014 Cerner Multum, Inc. Version: 7.01. Revision Date: 2013-11-14, 10:09:39 AM.