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Tacrolimus
What is Tacrolimus for?
Tacrolimus is an immunosuppressant inhibiting calcineurin so that the production of the release of cytokines will be suppressed as well. This lowers the activity of T-lymphocytes and hence the immune system. Tacrolimus is used for prophylaxis and treatment of organ transplant rejections and the treatment of eczema.
How to use it?
Tacrolimus can be administered topically as an ointment or orally as capsules and prolonged-release capsules. Administer with or without food but if gastrointestinal intolerance occurs, administer with food. For the prolonged-release capsules, they should not be opened, chewed or crushed. Listed below are the indications and the dosages.
Moderate to severe atopic dermatitis
Children above 2 years of age, adults and elderly
Ointment: Apply a thin layer to only the affected area twice daily by rubbing gently and completely until the symptoms resolve or after 6 weeks. By then, it has to be reevaluated.
Liver transplant
Adult and elderly
Immediate-release capsules: 0.1-0.15 mg/kg daily in 2 divided doses given every 12 hours in combination with corticosteroids.
Prolonged-release capsules: 0.1-0.2 mg/kg once daily initiated within 12-18 hours of transplantation in combination with corticosteroids.
Heart transplant
Adult and elderly
Immediate-release capsules: 0.075 mg/kg daily in 2 divided doses given every 12 hours in combination with an antimetabolite or an mTOR kinase.
Kidney transplant
Adult and elderly
Immediate-release capsules: 0.2 mg/kg daily in 2 divided doses given every 12 hours in combination with Azathioprine or Mycophenolate mofetil.
Prolonged-release capsules:
With Basiliximab induction: 0.15-0.2 mg/kg once daily.
Without Basiliximab induction: 0.1 mg/kg once within 12 hours before surgery; 0.2 mg/kg once daily after surgery.
What are the side effects of Tacrolimus?
Common side effects of Tacrolimus include cardiorespiratory failure, cardiac fibrillation, hair loss, bladder spasm, leukopenia and blurred vision.
Who should not take Tacrolimus?
- People who are allergic to Tacrolimus, Polyoxyl 60 hydrogenated castor oil (HCO-60) or any component of the formulation.
Pharmacist Tips:
- Apply only to the affected area by rubbing gently and completely.
- Do not occlude the applied area.
- Discontinue after the symptoms have resolved.
- Wash hands before and after use.
- Administer with or without food but if gastrointestinal intolerance occurs, administer with food.
- For the prolonged-release capsules, they should not be opened, chewed or crushed.
Common dosing schedule:
Oral Tacrolimus is taken twice daily, for example, in the morning and at night.
A thin layer of the ointment is applied twice daily, for example, in the morning and after the shower at night.
This schedule is for reference only, adjustments may be made according to individual needs.
Some common medications Tacrolimus may interact with:
- Immunosuppressants, e.g. Cyclosporin, Mycophenolate, Sirolimus
- Statins, e.g. Simvastatin, Atorvastatin, Pravastatin
- Aminoglycosides, e.g. Vancomycin, Amikacin, Tobramycin
- Antidiabetic agents, e.g. Metformin, Sitagliptin, Gliclazide
- QT-prolonging agents, e.g. Amiodarone, Dronedarone, Amisulpride
Tacrolimus may interact with many other medications. Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.
Where to buy Tacrolimus in Hong Kong?
In Hong Kong, Tacrolimus is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.
For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at https://www.drugoffice.gov.hk
Need more information?
For detailed information about the use of Tacrolimus in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.
Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.
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