Common Use

Prograf is an immunosuppressant used to prevent organ rejection after heart, kidney, small bowel, or bone marrow transplants. Its active ingredient, anhydrous tacrolimus, binds to the cytosolic protein FKBP 12, inhibiting calcineurin. This action suppresses the T-cell dependent immune response, the formation of cytotoxic lymphocytes, the proliferation of B cells that rely on T-helpers, and the production of interleukin-2, -3, and γ-interferon.

Dosage and Direction

The daily dose of Prograf should be divided into two intakes, spaced 12 hours apart. Take the capsules immediately after removing them from the blister pack with a full glass of water, on an empty stomach - either one hour before or 2-3 hours after a meal. Note that fatty foods reduce the drug's absorption. Dose adjustments may be necessary for patients with severe liver impairment.

Precautions

Prograf's immune-suppressing effects increase the risk of cancer (especially skin cancer) and infections. Avoid direct sunlight exposure. Regular monitoring of blood cell counts, kidney function, and liver function is essential while using this medication. Hispanic or African-American patients may have a higher risk of developing diabetes. Do not consume grapefruit juice while on Prograf. The drug can pass into breast milk and through the placenta, potentially harming the baby, discontinue breastfeeding during treatment. Inform your doctor if you have kidney or liver disease, high blood pressure, or if you have taken cyclosporine (Neoral, Sandimmune, Gengraf) within the past day.

Contraindications

Prograf should not be used in patients with hypersensitivity to tacrolimus, other macrolides, or hydrogenated castor oil.

Possible Side Effects

Side effects may include:

• Arterial hypertension or hypotension
• Angina, stroke, tachycardia, or arrhythmia
• Diarrhea, nausea, vomiting, or abdominal pain
• Changes in liver enzyme activity or kidney function
• Anemia, easy bruising, or changes in clotting
• Hyperglycemia, hyperpotassemia, or diabetes
• Seizures, joint pain, or muscle weakness
• Tremor, headache, or dizziness
• Vision changes, depression, mental confusion, or hallucinations
• Difficulty breathing, allergies, or photosensitivity
• High risk of tumors, fever, or swelling of extremities

Seek immediate medical attention for severe or persistent side effects.

Drug Interactions

Prograf can interact with various medications, including:

• Cyclosporine, potentially increasing its toxicity
• Drugs metabolized by cytochrome CYP 3A4, such as testosterone or cortisone
• Medications with high serum protein affinity, like anticoagulants, diabetic drugs, or NSAIDs
• Neurotoxic or nephrotoxic drugs, which may increase toxicity (e.g., aminoglycosides, vancomycin, NSAIDs)
• Potassium-saving diuretics or potassium-containing medications, risking hyperpotassemia

Prograf may reduce the effectiveness of vaccines, and live attenuated vaccines should be avoided. Always inform your doctor about all medications and herbal products you are using.

Missed Dose

Do not take a double dose. If it's almost time for your next dose, skip the missed one and continue with your regular schedule.

Overdose

Symptoms of Prograf overdose may include tremor, headache, nausea, vomiting, infections, rash, lethargy, elevated blood urea nitrogen, and increased serum creatinine and alanine transaminase (ALT) levels.

Storage

Store Prograf at room temperature, between 15-30°C (59-86°F).

Disclaimer

This information provides a general overview of Prograf and does not cover all instructions, interactions, or precautions. It should not be used for self-treatment or self-diagnosis. Always consult your healthcare provider for specific guidance. We do not guarantee the accuracy or reliability of this information and are not responsible for any consequences of its use or self-treatment.