Prograf
Prograf is a medicine that helps your body accept a transplanted organ by preventing your immune system from rejecting it.
Form
kapseli, kova
Strength
0.5 mg
Active Ingredient
Tacrolimus
Manufacturer
Astellas Pharma a/s
How to Use
Dosage
Your doctor will determine your dose based on your weight, usually 0.075-0.30 mg per kg of body weight per day immediately after organ transplant.
Method
Take Prograf twice daily, usually in the morning and evening. Take it on an empty stomach, at least 1 hour before food or 2-3 hours after food. Swallow the capsules whole with water. Avoid grapefruit and grapefruit juice. Do not swallow the desiccant from the package.
Important
Your doctor will determine the safe maximum daily dose and adjust it as needed.
Possible Side Effects
COMMON
- •High blood sugar, diabetes, high potassium in blood
- •Trouble sleeping
- •Tremors, headache
- •High blood pressure
- •Abnormal liver function test results
- •Diarrhea, nausea
- •Kidney problems
- •Low counts of blood cells (platelets, red or white blood cells), high white blood cell count, changes in red blood cell counts (seen in blood tests)
- •Low magnesium, phosphate, potassium, calcium, or sodium in blood; fluid retention; high uric acid or fats in blood; decreased appetite; high acidity in blood; other blood salt changes
- •Anxiety, confusion, disorientation, depression, mood changes, nightmares, hallucinations, mental disorders
- •Seizures, changes in consciousness, tingling or numbness (sometimes painful) in hands and feet, dizziness, difficulty writing, nerve problems
- •Increased sensitivity to light, eye problems
- •Ringing in the ears
- •Reduced blood flow in heart vessels, faster heartbeat
- •Bleeding, partial or complete blockage of blood vessels, low blood pressure
- •Shortness of breath, lung changes, fluid around lungs, sore throat, cough, flu-like symptoms
- •Stomach inflammation or ulcers causing pain or diarrhea, stomach bleeding, mouth inflammation or ulcers, fluid in abdomen, vomiting, stomach pain, indigestion, constipation, gas, bloating, loose stools, stomach issues
- •Changes in liver enzyme levels and function, yellow skin due to liver problems, liver tissue damage, liver inflammation
- •Itching, rash, hair loss, acne, increased sweating
- •Joint, limb, back, and foot pain, muscle spasms
- •Poor kidney function, reduced urine output, difficult or painful urination
- •General weakness, fever, fluid retention, pain and discomfort, increased alkaline phosphatase in blood, weight gain, feeling of abnormal temperature
- •Perforation of the gut: severe stomach pain, possibly with chills, fever, nausea, and vomiting.
- •Problems with the transplanted organ not working well.
- •Blurred vision.
RARE
- •Damage to small blood vessels (Thrombotic microangiopathy, HUS): symptoms include little or no urine production (sudden kidney failure), extreme tiredness, yellow skin or eyes, unusual bruising or bleeding, and signs of infection.
- •Thrombotic thrombocytopenic purpura (TTP): condition with damaged small blood vessels, fever, pinprick-sized red spots under the skin, extreme tiredness, confusion, yellow skin/eyes, sudden kidney failure (little/no urine), vision loss, and seizures.
- •Toxic epidermal necrolysis: skin and mucous membrane erosion and blistering, red swollen skin that may peel off large areas of the body.
- •Blindness.
- •Stevens-Johnson syndrome: widespread unexplained skin pain, facial swelling, severe blistering of skin, mouth, eyes, and genitals, hives, swollen tongue, red or purple rash that spreads; skin peeling.
- •Torsades de pointes: changes in heart rate, possibly with chest pain, fainting, dizziness, nausea, palpitations, and breathing difficulties.
- •Opportunistic infections (caused by bacteria, fungi, viruses, and parasites): prolonged diarrhea, fever, and sore throat.
- •Benign and malignant tumors: skin cancers and Kaposi's sarcoma (rare cancer with skin lesions like wounds). Symptoms include new or changing skin marks, wounds, or lumps.
- •Pure red cell aplasia (severe drop in red blood cells), hemolytic anemia (red blood cell breakdown with tiredness), and febrile neutropenia (fever with low white blood cells fighting infection). Symptoms can include tiredness, apathy, unusual pale skin, shortness of breath, dizziness, headache, chest pain, and cold hands/feet.
- •Agranulocytosis (severe drop in white blood cells, with mouth ulcers, fever, and infections). You might have sudden fever, chills, or sore throat.
- •Allergic and anaphylactic reactions: sudden itchy rash (hives), swelling of hands, feet, ankles, face, lips, mouth, and throat (which may make swallowing or breathing difficult), feeling faint.
- •Posterior Reversible Encephalopathy Syndrome (PRES): headache, confusion, mood changes, seizures, and vision problems.
- •Optic neuropathy (optic nerve disorder): vision problems like blurred vision, changes in color vision, difficulty seeing clearly, or narrowed field of vision.
- •Changes in blood clotting, decrease in all types of blood cells.
- •Dehydration.
- •Low protein or sugar in blood, high phosphate in blood.
- •Coma, brain hemorrhage, stroke, paralysis, brain disorder, speech and language difficulties, memory problems.
- •Clouding of the eye lens (cataract).
- •Hearing loss.
- •Irregular heartbeat, cardiac arrest, reduced heart pumping power, heart muscle disease, enlarged heart muscle, stronger heartbeats, abnormal ECG, abnormal heart rate and pulse.
- •Blood clot in a leg or arm vein, shock.
- •Breathing difficulties, airway disease, asthma.
- •Blocked intestine, high blood amylase, acid reflux, slow stomach emptying.
- •Eczema, burning sensation in the sun.
- •Joint diseases.
- •Inability to urinate, painful periods, abnormal menstrual bleeding.
- •Organ failure, flu-like symptoms, increased sensitivity to heat and cold, chest pressure, nervousness or unusual feeling, increased LDH enzyme in blood, weight loss.
- •Small skin bleeding due to clotted blood.
- •Increased muscle stiffness.
- •Deafness.
- •Fluid accumulation around the heart.
- •Acute breathing difficulties.
- •Cyst formation in the pancreas.
- •Blood flow problems in the liver.
- •Increased hair growth.
- •Thirst, falls, feeling of chest pressure, reduced mobility, wounds.
- •Muscle weakness.
- •Abnormal echocardiogram.
- •Liver failure, narrowing of the bile duct.
- •Painful urination with blood in urine.
- •Increased fatty tissue.
Important Warnings
- You must take this medicine daily for as long as your doctor tells you. You need to have regular check-ups with your doctor.
- Your doctor will order regular tests (blood, urine, heart, vision, nerve) to find the right dose for you.
- Do not use herbal remedies, especially St. John's Wort, as they can affect how Prograf works.
- Tell your doctor if you have liver problems or severe stomach pain, chills, fever, nausea, or vomiting.
- If you have diarrhea for more than one day, tell your doctor, as your Prograf dose might need to change.
Show 9 more warnings
- Inform your doctor if you experience changes in your heart's electrical activity (called 'QT prolongation').
- Protect your skin from sun and UV light by wearing protective clothing and sunscreen, as this medicine can increase the risk of skin cancer.
- If you need a vaccination, tell your doctor beforehand.
- Prograf can increase the risk of certain cancers (like lymphoma). Ask your doctor for more information.
- Tell your doctor if you get fever, bruises, unexplained tiredness, confusion, yellow skin/eyes, less urination, vision loss, or seizures. These could be signs of small blood vessel damage, especially if taking with sirolimus or everolimus.
- Avoid breathing in or direct skin/eye contact with Prograf solution or powder. Rinse skin/eyes if contact occurs.
- Tell your doctor about all other medicines you are taking, including herbal ones. Do not take Prograf with ciclosporin.
- If you visit a doctor who is not your transplant specialist, tell them you are taking tacrolimus.
- Do not drive or use machines if you feel dizzy, sleepy, or have vision problems after taking Prograf, especially if you also drink alcohol.