Tacrolimus (By mouth)

There may be other brand names for this medicine.

This medicine is not right for everyone. Do not use it if you had an allergic reaction to tacrolimus.

Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
Immediate-release capsule: You may take this medicine with or without food, but take it the same way each time (for example, always with food).
Extended-release capsule: Take it every morning on an empty stomach at least 1 hour before or 2 hours after breakfast. Swallow the extended-release capsule whole. Do not crush, break, or chew it.
Extended-release tablet: Take it on an empty stomach at the same time every day, usually in the morning. Swallow the extended-release tablet whole. Do not crush, break, or chew it.
This medicine is always used together with other medicines. Make sure you understand when to take each medicine during the day.
This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
Missed dose:
- You must use this medicine on a fixed schedule. Call your doctor or pharmacist if you miss a dose.
- Astagraf XL? (extended-release capsule) or Envarsus XR® (extended-release tablet): If you miss a dose and remember within 14 hours, take the missed dose right away. If more than 14 hours have passed since your regular dose time, skip the missed dose. Return to your regular schedule on the next day.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

There are many drugs that can interact with tacrolimus. Make sure your doctor knows about all other medicines you are using.
Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
Do not drink alcohol while you are using this medicine.
This medicine may interfere with vaccines. Ask your doctor before you get a flu shot or any other vaccines.

Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, heart disease, heart rhythm problems, high blood pressure, or any type of infection.
This medicine may cause the following problems:
- Higher risk of infection
- Higher risk of cancer, including skin cancer and lymphoma
- Diabetes
- High blood pressure, changes in heart rhythm, enlarged heart
- Nervous system disorder
- Kidney problems
- Anemia (low red blood cell counts)
- High potassium levels in your blood
- Gastrointestinal perforation (hole in your stomach or bowel)
This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Keep all medicine out of the reach of children. Never share your medicine with anyone.

Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Change in how much or how often you urinate, painful urination, bloody urine
Confusion, weakness, uneven heartbeat, trouble breathing, numbness in your hands, feet, or lips
Dizziness, lightheadedness, fainting
Fast, slow, or pounding heartbeat
Fever, chills, cough, stuffy or runny nose, sore throat, body aches
Headache, vision changes, tremors, seizures, tingling or numbness
Increased thirst or hunger
Rapid weight gain, swelling in your hands, ankles, or feet
Skin changes or growths
Swollen glands in your armpits or groin
Unusual bleeding, bruising, or weakness
Weakness on one side, confusion, clumsiness, trouble thinking clearly

Last Updated: 1/27/2017