tacrolimus (oral) (cont.)
What happens if I miss a dose (Prograf)?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose (Prograf)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking tacrolimus (Prograf)?
Grapefruit and grapefruit juice may interact with tacrolimus and lead to potentially dangerous effects. Do not use grapefruit products while you are taking tacrolimus.
Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.
Avoid exposure to sunlight or tanning beds. Tacrolimus can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Do not receive a "live" vaccine while using tacrolimus. The vaccine may not work as well during this time, and may not fully protect you from disease. Live vaccines include measles, mumps, rubella (MMR), Bacillus Calmette-Guérin (BCG), oral polio, rotavirus, smallpox, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
What other drugs will affect tacrolimus (Prograf)?
Tacrolimus can harm your kidneys. This effect is increased when you also use other medicines harmful to the kidneys, such as: chemotherapy, antiviral medication, pain or arthritis medicine, injected antibiotics, or medicines to treat a bowel disorder or prevent organ transplant rejection. You may need dose adjustments or special tests if you have recently used any of these medications.
Many drugs can interact with tacrolimus. Below is just a partial list. Tell your doctor about all other medicines you use, especially:
- other medicines to prevent rejection of a transplanted organ;
- St. John's wort;
- antacids such as Amphojel, Maalox, Mylanta, Rolaids, Rulox, and others;
- an antibiotic such as azithromycin (Zithromax, Zmax, Z-Pack), clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), and others;
- an antidepressant such as desipramine (Norpramin) or nefazodone;
- antifungal medication such as caspofungin (Cancidas), clotrimazole (Mycelex Troche), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), or voriconazole (Vfend);
- a barbiturate such as phenobarbital (Solfoton);
- birth control pills or hormone replacement;
- heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), dronedarone (Multaq), nifedipine (Nifedical, Procardia), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan, Tarka), and others;
- HIV/AIDS medication such as atazanavir (Reyataz), efavirenz (Sustiva, Atripla), fosamprenavir (Lexiva), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), and others;
- the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);
- seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), and others;
- steroid medicine such as dexamethasone (Cortastat, Dexasone, Solurex, DexPak) or methylprednisolone (Medrol); or
- stomach acid reducers such as cimetidine (Tagamet), lansoprazole (Prevacid), or omeprazole (Prilosec, Zegerid).
This list is not complete and there are many other drugs that can interact with tacrolimus. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
Where can I get more information?
Your pharmacist can provide more information about tacrolimus.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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