{"id":1579,"date":"2018-09-12T13:21:49","date_gmt":"2018-09-12T13:21:49","guid":{"rendered":"http:\/\/edren.org\/ren\/?page_id=1579"},"modified":"2023-11-10T10:16:38","modified_gmt":"2023-11-10T10:16:38","slug":"tacrolimus","status":"publish","type":"page","link":"https:\/\/edren.org\/ren\/handbook\/transplant-handbook\/immunosuppressive-drugs\/tacrolimus\/","title":{"rendered":"Tacrolimus"},"content":{"rendered":"
Tacrolimus (<\/span><\/strong><\/span>Adoport<\/span><\/strong><\/span>\/Advagraf \/Prograf)<\/span><\/strong><\/span><\/h5>\n
Current indication<\/span><\/strong><\/h5>\n
    \n
  • As the lead agent in standard triple therapy for all patients.<\/span><\/li>\n<\/ul>\n
    Dosage<\/span><\/strong><\/h5>\n
      \n
    • Adoport 0.05mg\/kg twice daily (i.e. 0.1mg\/kg\/day in 2 divided doses) (normally between 2 mg and 5 mg bd).<\/span><\/li>\n<\/ul>\n
      Preparation<\/span><\/strong><\/h5>\n
        \n
      • Adoport is available as 0.5 mg, 0.75mg, 1mg, 2mg and 5 mg capsules. <\/span>Prograf is available as 0.5 mg (cream), 1 mg (white) and 5 mg (greyish red) capsules.\u00a0 Note that Prograf and Adoport are clinically equivalent although they should not be used interchangeably in the same patient.<\/span><\/li>\n
      • In addition, the once a day preparation Advagraf is also available.<\/span><\/li>\n
      • Adoport is used in the initial post-operative period. Occasional patients may still be taking Prograf, if they did not switch to Adoport, when that was introduced in the unit.<\/span><\/li>\n
      • Patients can be switched to Advagraf once stable levels have been achieved if this is felt to be clinically beneficial.<\/span><\/li>\n<\/ul>\n
        Administration<\/span><\/strong><\/h5>\n
          \n
        • Oral route in most instances (well absorbed even in those with NG tubes).<\/span><\/li>\n
        • It is administered at 10 am and 10 pm.<\/span><\/li>\n
        • The capsules are taken on an empty stomach either 1 hour before or 2 – 3 hours after meals.<\/span><\/li>\n
        • Contents of the capsule can be suspended in water for NG administration.<\/span><\/li>\n
        • One fifth of the oral dose can be given as a continuous IV infusion in saline via non PVC bags\/tubing if absolutely necessary.<\/span><\/li>\n<\/ul>\n
          Levels<\/span><\/strong><\/h5>\n
            \n
          • Whole blood trough levels to be checked on Mondays, Wednesdays and Fridays.<\/span><\/li>\n
          • The target levels may be found in the immunosuppression section.<\/span><\/li>\n
          • In adult kidney transplant patients steady state may be reached 2-3 days after starting therapy or changing dose.<\/span><\/li>\n<\/ul>\n
            Pregnancy<\/span><\/strong><\/h5>\n