Side effects
Abnormal dreams agitation chills blurred vision confusion cough diarrhea dizziness dry mouth fever flushed, dry skin frequent urination fruit-like breath odor general feeling of discomfort or illness headache increased hunger increased thirst increased urination itching, skin rash joint pain loss of appetite loss of consciousness loss of energy or weakness mental depression muscle pains, trembling, or twitching nausea pale skin runny nose seeing or hearing things that are not there seizures shivering sore throat stomach pain sweating swelling of the feet or lower legs tingling trembling and shaking of the hands trouble breathing trouble sleeping unexplained weight loss unusual bleeding or bruising unusual tiredness or weakness vomiting A drug may have side effects in addition to the ones that are intended. Your doctor may also be able to provide you with information on how to avoid or lessen some of these side effects. Even though not all of these side effects are likely to happen, if they do, medical attention may be required. Belching, difficulty moving, a lack of strength, stiffness in the muscles Black, tarry stools, blistering, peeling, or loosening of the skin, bloating, bloody urine, constipation, dizziness, lower back or side pain, pain and fullness in the right upper stomach, pinpoint red spots on the skin, pounding or rapid pulse, red skin lesions, often with a purple center, red, irritated eyes, skin sores, ulcers, or white spots in the mouth or on the lips, weakness, and weight gain. Any of the following side effects should be discussed with your doctor right away: If any of the following side effects persist, are bothersome, or if you have any questions about them, consult your doctor: Increased pain sensitivity, chest pain, muscle cramps, numbness or pain in the legs, ringing in the ears, and cramps in the muscles Enlarged heart flushing of the face or neck weight loss unidentified incidence Less common More common Rare Some side effects may occur that usually do not need medical attention. As your body gets used to the medication, these side effects might go away during treatment.
Interactions
Prevent drinking. Don't consume anything with grapefruit. When tacrolimus is administered along with aluminum or magnesium hydroxide antacids, the serum level of tacrolimus may rise, increasing the possibility of toxicity. Consuming alcohol may increase the rate of tacrolimus release from extended-release formulations. Exercise caution with St. Johnson's Wort As coadministration with food reduces the rate and extent of absorption, take at least 1 hour before or 2 hours after a meal. The same time each day, take. Take on an empty stomach. Away from antacids; take separately. This herb induces the CYP3A4 metabolism of tacrolimus; therefore, monitoring tacrolimus whole blood trough concentrations may be warranted.
Contraindications
Anaphylactic reactions to IV formulation. Stay out of the sun and UV rays for extended periods of time. sugar diabetes. Driving and using large machinery shouldn't be done until you know how tacrolimus affects you. If you have an allergy to tacrolimus or any of its ingredients, avoid taking it. Acute or long-term kidney damage is possible; if kidney function declines, tacrolimus dosage should be decreased. Hypertension. Analyze blood sugar levels carefully. Monitor blood pressure regularly, and review medication list for relevant drug-drug interactions that may influence blood pressure. Nephrotoxicity. Nephrotoxicity: If acute or long-term kidney damage occurs, tacrolimus dosage should be decreased to prevent further kidney damage. Oral/injectable: Lymphoma and other cancers are among the serious side effects of tacrolimus that have been reported. Tacrolimus may make patients more susceptible to developing new cases of diabetes, which are a risk after transplant. Combination immunosuppression should be used with caution because patients receiving tacrolimus have an increased risk of bacterial, viral, fungal, and protozoal infections, including opportunistic infections. The signs and symptoms of anaphylaxis, such as hives, rash, itching, and trouble breathing or swallowing, may appear in patients receiving tacrolimus injection. severe infections Tacrolimus poses a risk for increased blood pressure that may require antihypertensive therapy. Tell your healthcare provider right away if you have any of the following signs or symptoms while receiving tacrolimus, which may suggest a serious reaction: decreased urination pain or burning on urination swelling of the arms, hands, feet, ankles or lower legs weight gain unusual bleeding or bruising seizures coma (loss of consciousness for a period of time) Topical: Serious side effects have been reported with topical tacrolimus including the following: Lymphoma and other malignancies: The risk of lymphomas after transplant appears related to intensity and duration of use of tacrolimus. If you experience any of the following while using tacrolimus ointment, it could be a sign of a serious reaction: swollen glands rash crusting, oozing, blistering or other skin infection symptoms cold sores chicken pox or other blisters swelling of the hands, arms, feet, ankles, or lower legs Tacrolimus can cause blurred vision, dizziness, and sleepiness. The frequency and length of tacrolimus use appear to be related to the risk of lymphomas after transplant. Use caution with other nephrotoxic drugs.
In clinical practice, whole blood trough levels have generally been in the range 5-20 ng/ml in liver transplant recipients and 10-20 ng/ml in kidney and heart transplant patients in the early post-transplant period. Administration should commence approximately 12 hours after the completion of surgery. As the pharmacokinetics of tacrolimus are unaffected by renal function, no dose adjustment should be required.
Therefore, changes in TTL-SD and TTL-CV in stable KTRs with no tacrolimus dose change require medical interest and attention. The higher the TTL-mean, the higher the TTL-SD. This study aimed to identify the tacrolimus trough levels (TTL)-mean, TTL-standard deviation (SD), and TTL- coefficient of variation (CV) as well as factors affecting these values over a 2-year period in clinically stable patients > 5 years after kidney transplantation (KT). Medical chart data, including TTL, graft rejection, and tacrolimus dose change during a 2-year period, between January 2017 and December 2018, were collected. Tacrolimus dose change significantly predicted the TTL-CV (p = .008).
Key Words: antifungal drug coverage, conversion factors, graft-versus-host disease, hematopoietic stem-cell transplant, HLA-matched donor, tacrolimus therapeutic levels J Hematol Oncol Pharm. To reach therapeutic tacrolimus levels, the patient had to be within the target range on 2 consecutive testings at least 24 hours apart. In a multivariate regression analysis, a 4/8 human leukocyte antigen (HLA)-matched donor significantly (P = .001) increased the time to target tacrolimus levels, and the incidence of diarrhea, although not significant (P = .093), resulted in increased time to reaching target tacrolimus levels.
Advagraf doses are usually reduced in the post-transplant period. Patients should be maintained on a single formulation of tacrolimus with the corresponding daily dosing regimen; alterations in formulation or regimen should only take place under the close supervision of a transplant specialist (see sections 4.4 and 4.8). The relationship between tacrolimus trough levels (C) and systemic exposure (AUC) for Advagraf is similar to that of Prograf.