Tacrolimus

Question 1

TACROLIMUS;
What are indications?

Answer 1

atopic eczema
prophylaxis of rejection of heart transplant
psoriasis

Question 2

TACROLIMUS;
What is its mechanism of action?

Answer 2

calciuneurin inhibitor which acts to suppress immune response

Question 3

TACROLIMUS;
What are important side effects?

Answer 3

cardiomyopathy mainly in children with tacrolimus blood trough concentrations much higher than recommended

Monitored by echodiography

Question 4

TACROLIMUS
Can it be used pregnancy and breastfeeding?

Answer 4

Avoid unless the benefits outweigh potential risk

crosses placenta and risk of premature delivery, premature delivery, intra-uterine growth restriction, hyperkalaemia and renal toxicity.

Maternal risk of hyperglycaemia, hypertension, pre-eclampsia and renal impairment.

Breastfeeding-amount too small to be harmful

Question 5

TACROLIMUS;
What is the MHRA warning advice for oral tacrolimus?

Answer 5

Inadvertent switching between oral tacrolimus products has been associated with reports of toxicity and graft rejection

Maintained on same brand

Question 6

TACROLIMUS;
What brands can be given at what formulation and frequency?

Answer 6

Adoport® and Prograf® are immediate-release capsules that are taken twice daily, once in the morning and once in the evening

Modigraf ® granules are used to prepare an immediate-release oral suspension which is taken twice daily, once in the morning and once in the evening.

Advagraf ® and Dailiport® are prolonged-release capsules that are taken once daily in the morning.

Question 7

TACROLIMUS;
Which brand is not interchangeable with others?

Answer 7

Envarsus.

Question 8

What are cautions?

Answer 8

UV light (avoid excessive exposure to sunlight and lamps)

Question 9

what are common side effects?

Answer 9

increased risk of infection
sensation abnormal
skin reactions