• Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What brand names are available for tacrolimus?

Prograf, Astagraf XL, Envarsus XR

Is tacrolimus available as a generic drug?


Do I need a prescription for tacrolimus?


What are the uses for tacrolimus?

  • Tacrolimus is used for the prevention of rejection of transplanted kidneys, liver, or heart.
  • It can be combined with steroids, azathioprine (Imuran Azasan) or mycophenolate mofetil (CellCept).

What are the side effects of tacrolimus?

Tacrolimus is associated with many and various side effects. These include:

Other side effects include

What is the dosage for tacrolimus?

  • Oral tacrolimus is taken twice daily.
  • Starting doses range between 0.075 mg/kg/day to 0.2 mg/kg/day (immediate release capsules).
  • 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.

Is tacrolimus safe to take if I'm pregnant or breastfeeding?

  • Tacrolimus crosses the placenta, but there have been no adequate studies in pregnant women to assess the effects on the fetus. Among women who have received tacrolimus while pregnant, high potassium levels and kidney injury in newborns have been reported. Therefore, tacrolimus should be used during pregnancy only when it is clearly needed.
  • Tacrolimus passes into breast milk. It is recommended that breastfeeding be discontinued while women are receiving oral tacrolimus.

What else should I know about tacrolimus?

What preparations of tacrolimus are available?

  • Capsule: 0.5, 1, and 5 mg
  • Tablets: 0.75, 1, 4 mg
  • Injection: 5 mg/ml

How should I keep tacrolimus stored?

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


Tacrolimus (Prograf, Astagraf XL, Envarsus XR) is a medication prescribed for the prevention of rejection of transplanted liver, heart, or kidneys. Side effects may include:

Drug interactions, dosing, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication. The brand Hecoria has been discontinued in the US.

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See more info: tacrolimus on RxList
Reference: FDA Prescribing Information