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BRAND NAMES: PROGRAF®, Sandoz tacrolimus, Envarsus PA, ADVAGRAF® 

Tacrolimus is available in the following formulations:
  • Tacrolimus oral suspension (prepared by transplant pharmacy)
  • Tacrolimus EXTENDED release (ADVAgraf®), a once a day capsule
  • Tacrolimus IMMEDIATE release (PROgraf®/Sandoz tacrolimus), a twice daily capsule
  • Tacrolimus PROLONG ACTING (Envarsus PA), a once a day tablet
printer.JPGClick to download the printer-friendly Tacrolimus info sheet HERE (PDF). 

What is this medication for?

Tacrolimus is a medication used to lower your body’s immune system to prevent your transplanted organ from being rejected. It makes your white blood cells weaker so they cannot damage the new organ.

How should I take this medication?

Tacrolimus should be taken with food to decrease stomach upset, but may be taken on an empty stomach if preferred. Be consistent, if you take it with food, always take it with food; if you take it on an empty stomach, always take it on an empty stomach.

You may take tacrolimus at the same time with stomach acid reducing medications (e.g. ranitidine (Zantac®), pantoprazole (Tecta®) etc.)

Avoid grapefruit or pomelo or Seville orange fruit/ juice while on this medication due to a serious interaction.

What are some possible side effects of this medication?

Presence of these side effects may be a sign of high tacrolimus levels. Report these symptoms to your doctor. 

Check your blood pressure regularly. You may need blood pressure medicines. Avoid foods high in salt or sodium.


Blood sugar will be monitored and treatment may be required for high blood sugars. Report any numbness or tingling in your hands and feet, increased thirst, dry mouth, fruity odour on your breath, or increased urinary frequency to your doctor. If you are diabetic, make sure you monitor your sugars regularly and take your diabetic medications as prescribed. 


‎Check with your doctor if any of these are bothersome or persistent. 

Check with your doctor if any of these are bothersome or persistent. 

Report these symptoms to your doctor. 

Report signs of infection (fever, chills, rapid heart rate, colds and flu) to your transplant team. Try to avoid close contact with people who have active infections. Practice frequent hand washing.

High tacrolimus levels may decrease your kidney function. Your tacrolimus levels will be closely monitored and the dose will be adjusted as needed. Notify your doctor if you notice any changes in your urine or the amount produced. 

Taking this medication may increase your risk of skin and other cancers. Please inform your transplant team if you are diagnosed with cancer. For additional information please see section on "Cancer Risk". 

SOURCE: Tacrolimus ( )
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