Tacrolimus (also known by the brand names Prograf and Advagraf) is an immunosuppressant medication used to prevent organ rejection after transplantation. It works by suppressing the body's immune system so it will not attack a transplanted organ. Tacrolimus was approved by the US Food and Drug Administration (FDA) in 1994 for use in kidney, heart, and liver transplants. It is often prescribed in conjunction with other forms of medication.

Tacrolimus can also be used in skin conditions like atopic dermatitis, psoriasis, and lichen planus along with autoimmune diseases like rheumatoid arthritis and Crohn's disease.

Tacrolimus is supplied under its generic name or the brand names Astagraf XL, Envarsus XR, and Prograf.

Tacrolimus is prescribed to prevent a rejection attack in patients who have undergone organ transplant surgery. It prevents white blood cells in the body from mistakenly attacking the transplanted organ. Tacrolimus is commonly prescribed to patients who have had a heart, kidney, liver, or lung transplant.

Tacrolimus is prescribed in conjunction with other immunosuppressants (like azathioprine or basiliximab) and steroid medication as a complete treatment plan.

Tacrolimus belongs to a classification of drugs known as immunosuppressants, even more specifically, calcineurin inhibitors. These drugs inhibit the enzyme calcineurin which helps activate T-cells—a type of white blood cell that plays an important role in the body’s immune system.

While the immune system plays a key role in keeping our bodies healthy, it can sometimes make mistakes. White blood cells can attack tissue already in the body, causing serious health complications (autoimmune diseases), or may attack new tissue introduced to the body via surgery (organ rejection). In some cases, an individual’s immune system may mistake a transplanted heart or lung (for instance) for a harmful foreign substance. White blood cells attack and kill the organ, which can be fatal.

Tacrolimus inhibits (blocks) the immune system’s response to a transplanted organ, increasing the likelihood that the body will accept the new organ.

Tacrolimus is not prescribed alone. It is commonly supplied with other immunosuppressant medication as well as steroids as a part of a complete treatment plan.

Tacrolimus has been shown to cause adverse side effects in some patients. If these reactions become severe or do not go away after a day or two, seek medical attention right away.

Mild side effects reported from tacrolimus use include:

• Gas
  
• Heartburn
  
• Stomach pain
  
• Constipation
  
• Diarrhea
  
• Nausea
  
• Vomiting
  
• Dizziness
  
• Insomnia
  
• Back pain
  
• Joint pain
  
• Stiffness
  
• Muscle weakness
  

More serious side effects include:

• Decreased urination frequency or amount
  
• Pain during urination
  
• Shortness of breath
  
• Rash
  
• Hives
  
• Itchy skin
  
• Fast or irregular heartbeat
  
• Fatigue
  
• Weight gain
  
• Unusual bleeding or bruising
  
• Swelling (usually in the hands, feet, arms, legs, or face)
  
• Seizures
  
• Confusion
  
• Loss of vision
  
• Mental depression
  

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a possibly serious adverse reaction to this medication and require treatment right away.

As with all medication, inform your doctor of any medical conditions you are currently managing. Tell them about any and all medication, prescription drugs, and supplements you are taking before starting treatment with tacrolimus. Tacrolimus can interact with substances in the body, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any antacids you have been taking, as well as if you have recently been taking cyclosporine before you start taking tacrolimus. Be sure to mention any herbal products you are using, including St. John’s wort.

Tell your doctor if you have or have ever had an irregular heartbeat, high levels of cholesterol, high or low levels of potassium in the blood, high or low levels of magnesium in the blood, high blood pressure, cystic fibrosis, or heart, kidney, liver, or lung disease.

In addition, let your doctor know if you are planning to become pregnant, are pregnant, or are currently breastfeeding before starting treatment with this medication. Call your provider if you become pregnant while you are taking tacrolimus.

Tacrolimus is commonly supplied as an extended-release oral capsule or tablet, or as a suspension liquid. The specific dosage of tacrolimus prescribed depends on the patient’s age and body weight. Take this medication exactly as ordered. Do not increase or discontinue the dosage without consulting with your health care provider first.

Keep all medication bottles out of reach of small children, and at room temperature. Avoid exposing the medication to excess heat or moisture.

If you begin to notice any adverse side effects like those listed above, notify your health care provider immediately.

Tacrolimus is currently only available via prescription. This means that a licensed health care provider must authorize the use of this medication.

If you are looking for a prescription, doctors on Sesame can write a prescription–or refill an existing one–during a virtual or in-person visit. Note that not all drugs can be prescribed via an online video appointment. In some cases, an in-person doctor visit is required for a prescription.

Depending on the medication, you can arrange for same-day pickup at your pharmacy. Book an appointment with a provider on Sesame today to discuss whether or not tacrolimus is right for you.

Note that all prescriptions are at the discretion of your health care provider. Sesame cannot guarantee that you will be provided a prescription after a video or in-person appointment. Providers on Sesame are unable to prescribe controlled substances. For more information about controlled substances, check out the Drug Enforcement Agency’s scheduling guidelines here.

Good news! If deemed clinically appropriate, providers on Sesame can write a prescription for tacrolimus to be picked up near you – often within the same day! Simply talk to a clinician and get your online doctor prescription or refill ordered right away for fast and convenient pickup from a pharmacy of your choice.

Note that all prescriptions are at the discretion of your healthcare provider.