10% Off
Remus 0.1%10 gm
Square Pharmaceuticals PLC.
৳324.00
Add to cart
Generic medicine
Tacrolimus: Brands, Price & Uses in Bangladesh
Tacrolimus is a calcineurin-inhibitor immunosuppressant with two distinct approved uses depending on formulation: Systemic (oral/IV) - FDA-approved: Prophylaxis of organ rejection in patients…
About Tacrolimus
Indications of Tacrolimus
Tacrolimus is a calcineurin-inhibitor immunosuppressant with two distinct approved uses depending on formulation:
- Systemic (oral/IV) - FDA-approved: Prophylaxis of organ rejection in patients receiving allogeneic kidney, liver, or heart transplants, used in combination with other immunosuppressive agents (e.g., corticosteroids, mycophenolate mofetil, or as part of a calcineurin-inhibitor-based regimen).
- Topical (ointment) - FDA-approved, second-line: Short-term and intermittent long-term treatment of moderate-to-severe atopic dermatitis in patients who have not responded adequately to, or are intolerant of, other topical prescription therapies.
- Off-label uses (not FDA-approved, evidence-supported in guidelines/literature): Certain autoimmune and inflammatory conditions such as lupus nephritis, severe ulcerative colitis, and prevention/treatment of graft-versus-host disease after hematopoietic stem cell transplant, used under specialist supervision.
Systemic Tacrolimus is always used in combination with other immunosuppressants and is not intended as monotherapy for transplant rejection prophylaxis.
Dosage & Administration of Tacrolimus
| Indication | Population | Typical Dosing |
|---|---|---|
| Kidney/Liver/Heart transplant (oral, immediate-release) | Adults | Initial dose approximately 0.1-0.2 mg/kg/day in two divided doses, started within 24 hours post-transplant; subsequently adjusted to maintain target trough blood concentrations, in combination with other immunosuppressants. |
| Kidney/Liver transplant | Pediatric | Generally higher weight-based doses than adults (per transplant protocol); dosing individualized under specialist supervision with trough-level monitoring. |
| IV formulation | Adults (only when oral not feasible) | Approximately 0.03-0.05 mg/kg/day as continuous IV infusion; converted to oral therapy as soon as possible due to anaphylaxis risk with IV castor-oil-derivative vehicle. |
| Atopic dermatitis (topical ointment) | Adults and children ≥2 years | Apply a thin layer of 0.03% (children 2-15 years) or 0.03%/0.1% (adults) ointment to affected skin twice daily; discontinue once clearing occurs; not for long-term continuous use without physician review. |
Dose must be individualized based on trough blood concentrations, renal/hepatic function, concomitant immunosuppressants, and clinical response. Tacrolimus must be taken exactly as prescribed; do not change the dose, switch between brands/formulations, or stop the medicine without consulting the transplant physician, as this can precipitate organ rejection.
Side Effects of Tacrolimus
Boxed warning-level risks (systemic use): Increased susceptibility to infection (bacterial, viral, fungal, opportunistic) and increased risk of malignancy, particularly lymphoma and skin cancers, due to the degree of overall immunosuppression. Tacrolimus may also cause nephrotoxicity and neurotoxicity, requiring regular monitoring of renal function and blood trough levels.
Common systemic side effects include:
- Tremor, headache, insomnia
- Hypertension
- Hyperglycemia and new-onset diabetes mellitus after transplant
- Hyperkalemia, hypomagnesemia
- Diarrhea, nausea, vomiting
- Nephrotoxicity (elevated creatinine)
- Peripheral edema
Serious/rare effects: Seizures, posterior reversible encephalopathy syndrome (PRES), QT prolongation, thrombotic microangiopathy, and (topical use) a boxed warning noting rare post-marketing reports of malignancy (skin cancer, lymphoma) with topical calcineurin inhibitors, although a causal relationship has not been established; topical use is intended as second-line, short-term/intermittent therapy.
Topical use commonly causes application-site burning, stinging, pruritus, and erythema, especially in the first days of treatment.
Contraindications of Tacrolimus
Tacrolimus is contraindicated in patients with known hypersensitivity to tacrolimus. The intravenous formulation is additionally contraindicated in patients hypersensitive to HCO-60 (polyoxyl 60 hydrogenated castor oil), a component of the IV vehicle, due to risk of anaphylaxis.
Frequently Asked Questions about Tacrolimus
What is Tacrolimus used for?
Tacrolimus is used to prevent organ rejection after kidney, liver, or heart transplant (given with other immunosuppressants), and as a topical ointment for moderate-to-severe atopic dermatitis (eczema) that has not responded to other treatments.
Can I stop taking Tacrolimus if I feel fine?
No. Do not stop, skip doses, or change your Tacrolimus dose without consulting your transplant physician, even if you feel well, because stopping abruptly can trigger organ rejection. For topical use, follow your physician's instructions on duration.
Why do I need regular blood tests while on Tacrolimus?
Tacrolimus has a narrow therapeutic range - too little risks organ rejection, too much increases toxicity (kidney and nerve damage). Regular blood trough-level tests, along with kidney function, blood pressure, and blood sugar monitoring, are required throughout systemic treatment.
Can I drink grapefruit juice while taking Tacrolimus?
No. Grapefruit juice can significantly increase Tacrolimus blood levels and raise the risk of side effects such as kidney toxicity and tremor. It should be avoided during treatment.
Is Tacrolimus safe during pregnancy?
Tacrolimus should be used in pregnancy only if clearly needed, such as to maintain a transplanted organ, and only under close specialist supervision, as it crosses the placenta and carries potential risks to the fetus that must be weighed against the risk of untreated organ rejection.
What are the serious risks of long-term Tacrolimus use?
Long-term systemic Tacrolimus use increases the risk of infections and certain cancers (such as lymphoma and skin cancer) due to immune suppression, and can cause kidney damage, high blood pressure, and high blood sugar. Regular physician follow-up is essential to monitor for these risks.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.