Astagraf XL (Tacrolimus)

Astellas Pharma, Inc.

Nationwide Prescription Connection (NPC) is an experienced advocacy service that helps connect patients to manufacturer provided free and discount programs. We can help the uninsured, under insured, those in the Medicare gap also known as the "doughnut hole", or even those needing help with expensive co-pays.  Our web site makes it easy for you to enter the medications you are taking, along with some basic patient information, and then finds the program that is right for you.

Nationwide Prescription Connection (NPC) is an experienced advocacy service that helps connect patients to manufacturer provided free and discount programs. We can help the uninsured, under insured, those in the Medicare gap also known as the "doughnut hole", or even those needing help with expensive co-pays.  Our web site makes it easy for you to enter the medications you are taking, along with some basic patient information, and then finds the program that is right for you.

Calcineurin Inhibitors

Organ Transplant, Rejection Prophylaxis

Tacrolimus is used with other medications to prevent rejection of a kidney transplant. This medication belongs to a class of drugs known as immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new organ as if it were your own. This medication may also be used with other medications to prevent rejection of other types of transplant (such as heart).

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking tacrolimus and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth on an empty stomach (1 hour before or 2 hours after a meal) as directed by your doctor, usually once daily in the morning. Talk to your doctor about how to take this medication if you have nausea or an upset stomach. If you take the extended-release capsules, swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects. If you take the extended-release tablets, do not crush or chew the tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Dosage is based on your weight, medical condition, blood test results (for example, tacrolimus trough levels), response to treatment, and previous dose of tacrolimus (if switching from the form of this medication that is taken twice daily). Tacrolimus is available in different formulations (such as immediate and extended-release). Do not switch between different forms of tacrolimus without consulting your doctor. Do not increase your dose or take this medication more often without your doctor's approval. Your condition will not improve any faster and the risk of serious side effects may be increased. Also, do not stop taking this medication without your doctor's approval. Take this medication regularly in order to get the most benefit from it. It is important to take all doses on time to keep the amount of medicine in your body at a constant level. Remember to take it at the same time each day.

Shaking, headache, diarrhea, nausea/vomiting, upset stomach, and trouble sleeping may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Tell your doctor right away if you have any serious side effects, including: swelling ankles/feet, signs of kidney problems (such as change in the amount of urine), mental/mood changes, hearing problems (such as hearing loss, ringing in the ears), increased tiredness, numbness/tingling of the hands/feet, dizziness, pain/redness/swelling of arms or legs, easy bruising/bleeding, yellowing skin/eyes, dark urine, persistent nausea/vomiting, severe stomach/abdominal pain, muscle weakness, severe leg pain. This medication may also increase your risk of getting a rare but very serious (sometimes fatal) brain infection (progressive multifocal leukoencephalopathy-PML). Get medical help right away if any of these rare but very serious side effects occur: clumsiness, loss of coordination, weakness, sudden change in your thinking (such as confusion, difficulty concentrating), difficulty moving your muscles, problems with speech, seizure, vision changes. Get medical help right away if you have any very serious side effects, including: fainting, fast/irregular heartbeat, severe dizziness, chest/jaw/left arm pain, black stools, vomit that looks like coffee grounds. This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high. Your doctor may control your blood pressure with medication. Tacrolimus may cause diabetes. Tell your doctor or pharmacist if you experience symptoms of high blood sugar such as increased thirst/hunger, frequent urination. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Some products that may interact with this drug include: aluminum/magnesium antacid, cyclosporine, sirolimus, temsirolimus, ziprasidone, other drugs that may increase the level of potassium in the blood (such as "water pills" including amiloride, spironolactone), other drugs that weaken the immune system/increase the risk of infection (such as natalizumab, rituximab). Avoid alcohol when using this medication because it may cause the medication to be released too quickly and increase the risk of side effects. Other medications can affect the removal of tacrolimus from your body, which may affect how tacrolimus works. Examples include caspofungin, cimetidine, danazol, nefazodone, ethinyl estradiol, methylprednisolone, St. John's wort, azole antifungals (such as itraconazole/voriconazole), calcium channel blockers (such as nifedipine, verapamil), HIV protease inhibitors (such as nelfinavir, ritonavir), other protease inhibitors (such as boceprevir, telaprevir), rifamycins (such as rifampin, rifabutin), certain anti-seizure drugs (such as carbamazepine, phenobarbital, phenytoin), among others.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222.

If you take the extended-release capsules: If you miss a dose, take it as soon as you remember. If it is more than 14 hours after the time you would usually take it, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up. If you take the extended-release tablets: If you miss a dose, take it as soon as you remember. If it is more than 15 hours after the time you would usually take it, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.