tacrolimus, Prograf, Astagraf XL, Hectoria (cont.)

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PREPARATIONS: Capsule: 0.5, 1, and 5 mg. Injection: 5 mg/ml

STORAGE: Tacrolimus should be stored at room temperature between 15 C - 30 C (59 F - 86 F).

DOSING: Oral tacrolimus is taken twice daily. Starting doses range between 0.075 mg/kg/day to 0.2 mg/kg/day. Doses vary widely and are based on tests that measure the amount of tacrolimus in the blood. Taking tacrolimus with food can reduce some of the abdominal pain that can occur with this medicine; however, food can reduce the amount of tacrolimus that is absorbed. This is especially true with fatty foods. Capsules should be taken consistently with or without food in order to avoid major swings in blood levels. Grapefruit juice increases blood levels of tacrolimus and should be avoided. The injection is only used for patients who cannot tolerate tacrolimus capsules.

DRUG INTERACTIONS: The destruction of tacrolimus by the body may be inhibited by a large number of drugs, resulting in higher blood levels of tacrolimus and possibly increasing its side effects. Such drugs include lansoprazole (Prevacid), omeprazole (Prilosec), protease inhibitors (for example, nelfinavir [Viracept] and ritonavir [Norvir]), bromocriptine (Parlodel), cimetidine (Tagamet), cisapride (Propulsid), clarithromycin (Biaxin), cyclosporine (Sandimmune; Neoral), danazol (Danocrine), diltiazem (Cardizem, Tiazac), erythromycin, fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), metoclopramide (Reglan), methylprednisolone (Medrol), nicardipine (Cardene), troleandomycin (Tao), and verapamil (Calan, Isoptin, Verelan, Covera-HS). Grapefruit juice has a similar effect on tacrolimus and should be avoided.

Medically Reviewed by a Doctor on 2/17/2015

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