What is Tacrolimus?
Tacrolimus is a drug used to suppress the immune system and prevent it from rejecting the transplanted kidney. The dose is worked out according to your body weight. It will be adjusted depending on the drug levels in your blood.
There are several different versions of Tacrolimus. It will be prescribed for you by its trade name (for example, Adoport, Prograf or Advagraf) and it’s important the same brand is continued unless advised to change by the doctor or nurse in transplant clinic.
How do I take Tacrolimus?
Tacrolimus should be taken at approximately 10am and 10pm. You will be given more information by your healthcare professional.
It should be taken on an empty stomach. You should not eat anything for about one hour before and two hours after you take it.
Tacrolimus should not be taken with grapefruit (either the fruit or the juice) as this affects its absorption.
Should I take Tacrolimus on the day that I have a clinic appointment?
On the day that you attend your clinic you should not take your morning dose, but bring it with you to take after you have had your blood test. This is to make sure that the blood sample is taken approximately 12 hours after the last dose. This allows the drug concentration to be accurately measured.
Does Tacrolimus have any side effects?
There are several possible side effects that you may notice and these might particularly occur in the early weeks after the transplant when the doses and the level aimed are higher. However many people do NOT experience any side effects.
Side effects include:
- Tremor or pins and needles in the hands or feet
- Tacrolimus may affect the breakdown of glucose by the body. This makes your blood sugar too high and in some patients causes permanent diabetes. If this occurs you may need to have tablets or insulin injections to control the blood sugar
- Raised blood cholesterol
- Poor appetite or feeling sick
- Constipation or trapped wind
- Insomnia (difficulty in sleeping), vivid dreams/ nightmares/ hallucinations
- Hair loss
- Absorption of the contraceptive pill is affected by Tacrolimus so you should discuss this with the renal doctor
- Increased risk of infection: if you develop ‘flu-like symptoms, cough, sore throat, or a high temperature contact the renal team promptly.
It is important to tell your doctor of any side effects or unusual symptoms that you are experiencing. These may indicate that your blood concentrations of Tacrolimus are too high and the dose may need to be changed.
If you take Tacrolimus, you may be more at risk of getting infection.
If you come into skin contact with someone with chickenpox or shingles, or if you develop chickenpox or shingles, you need to contact your doctor immediately.
Can I still be vaccinated?
Some vaccines contain a live form of the virus. These are called live vaccines. If you are taking Tacrolimus, you cannot have live vaccines.
Please talk to the renal team or your doctor if you are not sure about this.
It is still important to get the following:
- Flu vaccine: recommended
- Covid-19 vaccine: recommended
- Pneumovax: recommended
- Shingles vaccine (Shingrix): make sure that you get the NON LIVE formulation
Is it safe to be in the sun?
Limit the amount of time you spend in the sunlight and avoid exposure to ultraviolet (UV) light such as tanning machines. Wear protective clothing and use a sunscreen with a high sun protective factor (SPF).
Is it safe to become pregnant while I am taking Tacrolimus?
You should not plan a pregnancy if you are on Tacrolimus and should use effective contraception if sexually active. If you wish to become pregnant this must be discussed with your renal doctor.
Can I take other medicines while I am taking Tacrolimus?
Before starting any other medication or buying any over the counter (OTC) and herbal medicines you should discuss this with your doctors or pharmacist.
Supply of Tacrolimus
Tacrolimus is a hospital-only medication, so it will be delivered to your house either via the Trust community pharmacy (Pharm@Sea) or a homecare company called Polarspeed. Tacrolimus will NOT be supplied by your GP and local community pharmacy.
Who can I contact for further information or advice?
If you have any queries or you have had a blood test done please inform the Renal Post-Transplant Nurses. If no one is answering the phone please leave a message and we will return the call.