Tacrolimus (Systemic)

(ta KROE li mus)

Brand Names: U.S.

  • Hecoria
  • Prograf

Brand Names: Canada

  • Advagraf
  • Prograf

What key warnings do I need to know about before giving this drug to my child?

  • This drug may add to your child's chance of getting lymphoma or other cancers.
  • Very bad infections have happened in patients who take this drug. Talk with the doctor.
  • Sometimes drugs are not safe when your child takes them with other drugs. Taking them together can cause bad side effects. This is one of those drugs. Be sure to talk to your child’s doctor about all the drugs your child takes.

Is it safe for my child to take this drug?

  • Not if your child has an allergy to tacrolimus or any other part of this drug.
  • Be sure to let the doctor know if your child has any allergies or side effects to drugs, foods, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

Why does my child need this drug?

  • It is used to keep the body from harming the organ after an organ transplant.
  • It is used to treat diseases of the immune system.

How is this drug given?

  • Give this drug with or without food. Always give with food or always give on an empty stomach.
  • Have your child swallow whole. Do not let your child chew, break, or crush.
  • Liquid:
  • There is a liquid (suspension) if your child cannot swallow pills. Shake well before use.
  • Children who have feeding tubes may also use the liquid. Flush the feeding tube before and after this drug is given.
  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, get an oral syringe, a dropper, a spoon, or a cup (only for older children) from your pharmacist.
  • Shot:
  • It is given as a shot into a vein over a period of time.

How long does this drug take to work?

  • It may take a few weeks to see the full effect.

What do I do if my child misses a dose?

  • Give a missed dose as soon as you think about it.
  • If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
  • Do not give 2 doses or extra doses.
  • Do not change the dose or stop your child's drug. Talk with your child's doctor.

What safety measures do I need to take when my child is using this drug?

  • The chance of cancer is higher after using this drug. Talk with the doctor.
  • If your child has high blood pressure, talk with the doctor.
  • If your child has kidney disease, talk with the doctor.
  • If your child has liver disease, talk with the doctor.
  • Have your child's blood work checked often. Talk with your child's doctor.
  • Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
  • Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
  • Do not give antacids, cholestyramine, or colestipol within 2 hours of this drug.
  • Do not have other household members get the oral polio vaccine while your child is taking this drug.
  • Talk with the doctor before your child gets any vaccines. Use with this drug may either raise the chance of very bad infection or make the vaccine not work as well.
  • Tell dentists, surgeons, and other doctors that your child is using this drug.
  • Avoid giving your child grapefruit and grapefruit juice.
  • Your child may get sunburned more easily. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects him/her from the sun.

What are some side effects of this drug?

  • High blood pressure.
  • Your child may have more chance of getting infections. Avoid crowds and people with infections, colds, or flu.
  • Kidney function that gets worse.
  • Headache.
  • Feeling dizzy. Have your child get up slowly over a few minutes when sitting or lying down. Have your child be extra careful climbing stairs.
  • Upset stomach or throwing up. Many small meals and good mouth care may help. Older children may suck hard, sugar-free candy.
  • Loose stools (diarrhea).
  • Not able to sleep.

When do I need to call my child's doctor?

  • If any of this news causes you to be worried, any of the unwanted side effects happen, or if your child is not better after taking this drug.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.
  • If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
  • If your child shows any signs of infection. These include a fever of 100.5°F (38°C) or higher, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color or sputum, pain with passing urine, mouth sores, wound that will not heal, or anal itching or pain.
  • If your child has a bad headache.
  • If your child has any bruising or bleeding.
  • If your child has more trips to the bathroom, more thirst, or weight loss.
  • If your child is not able to pass urine.
  • If your child has swelling.
  • If your child gets a rash.
  • If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

  • Capsule:
  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.
  • Liquid:
  • Store liquid (suspension) at room temperature. Throw away any part not used after 2 months.
  • Shot:
  • The shot will be given to your child in a hospital or doctor's office. You will not store it at home.

General drug facts

  • If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
  • You may get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
  • Get rid of this drug when your child no longer needs it or if the drug is outdated.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.
  • In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.
  • Do not share your child's drug with others and do not give anyone else's drug to your child.
  • Keep all drugs out of the reach of children and pets.
  • Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
  • These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
  • Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
  • If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.