tacrolimus

ROUTE	ONSET	PEAK	DURATION
PO	rapid	1.3–3.2 hr*	12 hr
PO-ER	unknown	unknown	24 hr
IV	rapid	unknown	8–12 hr
Topical‡	unknown	1–2 wk	unknown

Noted primarily for PO and IV use, but should be considered for topical use.

Drug-drug:

Aminoglycosides, amphotericin B, cisplatin, nucleotide reverse transcriptase inhibitors, protease inhibitors, or cyclosporine may ↑ risk of nephrotoxicity; allow 24 hr to pass after stopping cyclosporine before starting tacrolimus.
Potassium-sparing diuretics, ACE inhibitors, or angiotensin II receptor blockers may ↑ risk of hyperkalemia.
Strong CYP3A4 inhibitors, including chloramphenicol, clarithromycin, cobicistat, itraconazole, ketoconazole, nefazodone, posaconazole, protease inhibitors, and voriconazole, may significantly ↑ levels; ↓ tacrolimus dose by 2/3 when used with voriconazole or posaconazole; closely monitor tacrolimus whole blood trough concentrations.
Mild CYP3A4 inhibitors and moderate CYP3A4 inhibitors, including amiodarone, calcium channel blockers, cimetidine, clotrimazole, danazol, erythromycin, ethinyl estradiol, fluconazole, imatinib, isavuconazonium, lansoprazole, letermovir, nilotinib, and omeprazole, may ↑ levels and risk of toxicity; closely monitor tacrolimus whole blood trough concentrations and adjust tacrolimus dose, if needed.
Magnesium/aluminum hydroxide and metoclopramide may ↑ levels and risk of toxicity; closely monitor tacrolimus whole blood trough concentrations and adjust tacrolimus dose, if needed.
Strong CYP3A4 inducers, including carbamazepine, phenobarbital, phenytoin, rifabutin, and rifampin, may ↓ levels and effectiveness; ↑ tacrolimus dose and closely monitor tacrolimus whole blood trough concentrations.
Mild CYP3A4 inducers and moderate CYP3A4 inducers, including methylprednisolone or prednisone, may ↓ levels and effectiveness; closely monitor tacrolimus whole blood trough concentrations and adjust tacrolimus dose, if needed.
Vaccinations may be less effective if given concurrently with tacrolimus (avoid use of live-virus vaccines).
May ↑ levels and risk of toxicity of mycophenolate mofetil or mycophenolic acid.
Caspofungin may ↓ levels and effectiveness; closely monitor tacrolimus whole blood trough concentrations and adjust tacrolimus dose, if needed.
Cannabidiol may ↑ levels and risk of toxicity; monitor tacrolimus levels and adjust dose as necessary.

Drug-Natural Products:

Astragalus, echinacea, and melatonin may interfere with immunosuppression.
St. John's wort may ↓ levels and effectiveness; ↑ tacrolimus dose and closely monitor tacrolimus whole blood trough concentrations.
Schisandra sphenanthera may significantly ↑ levels and risk of toxicity; closely monitor tacrolimus whole blood trough concentrations.

Drug-Food:

Food↓ the rate and extent of GI absorption.
Grapefruit juice may ↑ levels and risk of toxicity; avoid concurrent use.

Route/Dosage ⬆ ⬇

Because of the potential risk for anaphylaxis, the IV route of administration should be reserved for those patients unable to take the drug orally. Extended-release capsules are not interchangeable with immediate-release capsules/granules or other extended-release products. When converting between immediate-release capsules and granules, the total daily dose should remain the same. Black patients may require a higher dose to achieve desired tacrolimus trough concentrations. Patients with cystic fibrosis may also require a higher dose for lung transplantation due to ↓ bioavailability.

Kidney Transplantation

PO (Adults ): Immediate-release capsules (in combination with azathioprine): 0.2 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration; Immediate-release capsules (in combination with mycophenolate mofetil and IL-2 antagonist): 0.1 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration; Extended-release capsules (Astagraf XL) (in combination with basiliximab induction): 0.15 mg/kg once daily (to be started either before or within 48 hr of completion of transplant); Extended-release capsules (Astagraf XL) (without basiliximab induction): 0.1 mg/kg given as single dose preoperatively within 12 hr prior to reperfusion, followed by 0.2 mg/kg once daily started postoperatively ≥4 hr after preoperative dose and within 12 hr after reperfusion; Conversion from immediate-release capsules to extended-release capsules (Envarsus XR): Initiate extended-release treatment with a once-daily dose that is 80% of the total daily dose of the immediate-release product (also appropriate for Black patients).
PO (Children ): Immediate-release capsules or suspension: 0.3 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration.
IV (Adults ): 0.03–0.05 mg/kg/day as a continuous infusion initially; titrate to achieve recommended blood concentration.

Liver Transplantation

PO (Adults ): Immediate-release capsules: 0.1–0.15 mg/kg/day in 2 divided doses initially; titrate to achieve recommended blood concentration.
PO (Children ): Immediate-release capsules: 0.15–0.2 mg/kg/day in 2 divided doses initially; titrate to achieve recommended blood concentration. Suspension: 0.2 mg/kg/day in 2 divided doses initially; titrate to achieve recommended blood concentration.
IV (Adults ): 0.03–0.05 mg/kg/day as a continuous infusion initially; titrate to achieve recommended blood concentration.
IV (Children ): 0.03–0.05 mg/kg/day.

Heart Transplantation

PO (Adults ): Immediate-release capsules: 0.075 mg/kg/day in 2 divided doses initially; titrate to achieve recommended blood concentration.
PO (Children ): Immediate-release capsules or suspension (without antibody induction treatment): 0.3 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration. Immediate-release capsules or suspension (with antibody induction treatment): 0.1 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration.
IV (Adults ): 0.01 mg/kg/day as a continuous infusion initially; titrate to achieve recommended blood concentration.

Lung Transplantation

PO (Adults ): Immediate-release capsules: 0.075 mg/kg/day in 2 divided doses initially; titrate to achieve recommended blood concentration.
PO (Children ): Immediate-release capsules or suspension (without antibody induction treatment): 0.3 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration. Immediate-release capsules or suspension (with antibody induction treatment): 0.1 mg/kg/day in 2 divided doses initially; titrate to achieve recommended whole blood trough concentration.
IV (Adults ): 0.01–0.03 mg/kg/day as a continuous infusion initially; titrate to achieve recommended blood concentration.

Atopic Dermatitis

(Adults ): Apply 0.03% or 0.1% ointment twice daily. Discontinue when signs/symptoms of atopic dermatitis resolve.
(Children ≥2–15 yr): Apply 0.03% ointment twice daily. Discontinue when signs/symptoms of atopic dermatitis resolve.

Availability ⬆ ⬇

(Generic available)

Capsules: 0.5 mg; 1 mg; 5 mg
Extended-release capsules (Astagraf XL): 0.5 mg; 1 mg ; 3 mg; 5 mg
Extended-release tablets (Envarsus XR): 0.75 mg; 1 mg; 4 mg
Granules for oral suspension: 0.2 mg/pkt; 1 mg/pkt
Solution for injection: 5 mg/mL
Topical ointment: 0.03%; 0.1%

Assessment ⬆ ⬇

Assess for signs/symptoms of PRES (headache, altered mental status, seizures, visual disturbances, hypertension) periodically during therapy. Confirm diagnosis by radiologic procedure. If PRES is suspected or diagnosed, maintain BP control and immediately ↓ immunosuppression. Symptoms are usually reversed on ↓ or discontinuation of immunosuppression.
Monitor for signs/symptoms of opportunistic infection (persistent fever, malaise, sore throat, unusual bleeding or bruising).
Monitor for signs/symptoms of neurotoxicity (headache, altered mental status, seizure, visual disturbance, delirium, coma).
Prevention of Organ Rejection: Monitor BP closely during therapy. Hypertension is a common complication of tacrolimus therapy and should be treated.
- Observe patients receiving IV tacrolimus for the development of anaphylaxis (rash, pruritus, laryngeal edema, wheezing) for ≥30 min and frequently thereafter. If signs/symptoms of anaphylaxis occur, stop infusion and initiate treatment.
Atopic Dermatitis: Assess skin lesions before and periodically during therapy.
- Use only for short time, not continuously, and in the minimum dose possible to ↓ risk of developing skin cancer.

Lab Test Considerations:

Tacrolimus blood level monitoring may be helpful in the evaluation of rejection and toxicity, dose adjustments, and assessment of compliance. For kidney transplantation, during the 1st 3 mo, most patients maintained tacrolimus whole blood concentrations of 7–20 ng/mL and then 5–15 ng/mL through 1 yr. For de novo kidney transplantation, during the 1st mo, most patients maintained tacrolimus whole blood concentrations of 6–11 ng/mL and then 4–11 ng/mL through mo 1. For heart transplantation, from wk 1 to 3 mo, most patients maintained tacrolimus trough whole blood concentrations of 8–20 ng/mL and then 6–18 ng/mL from 3–18 mo post-transplant.
- Monitor serum creatinine, potassium, and glucose closely. ↑ serum creatinine and ↓ urine output may indicate nephrotoxicity. May also cause insulin-dependent post-transplant diabetes mellitus (incidence is higher in Black and Hispanic patients).
- May also cause hyperuricemia, hypokalemia, hyperkalemia, hypomagnesemia, metabolic acidosis, metabolic alkalosis, hyperlipidemia, hyperphosphatemia, hypophosphatemia, hypocalcemia, and hyponatremia.
- Monitor CBC with differential. May cause anemia, leukocytosis, and thrombocytopenia.

Implementation ⬆ ⬇

Do not confuse Prograf with Prozac. Do not confuse tacrolimus with tamsulosin.
- Do not confuse immediate-release tacrolimus with extended-release tacrolimus.
- Should only be prescribed by health care providers experienced with immunosuppressive therapy and organ transplant patients.
Begin therapy with tacrolimus no sooner than 6 hr post-transplantation. Concurrent therapy with corticosteroids is recommended in the early postoperative period.
- Tacrolimus should not be used concurrently with cyclosporine. Tacrolimus or cyclosporine should be discontinued ≥24 hr before starting the other.
- Oral therapy is preferred because of the risk of anaphylactic reactions with IV tacrolimus. IV therapy should be replaced with oral therapy as soon as possible.
- Adults should be started at the lower end of the dose range; children require higher doses to maintain blood trough concentrations similar to adults.
- Immediate and extended-release capsules are not interchangeable.
PO: Initiate oral doses 8–12 hr after discontinuation of IV doses. Administer with or without food, but should be consistent, and at same time each day.
- Extended-release capsules: Administer at the same time each day, preferably in the morning, on an empty stomach ≥1 hr before or 2 hr after breakfast. DNC: Swallow capsules whole; do not chew, divide, or crush.
Topical Do not use continuously for a long time.
Topical Wash hands before applying. Apply a thin layer of ointment twice daily to affected skin. Use smallest amount of ointment needed to control signs and symptoms of eczema. Do not cover treated area with bandages, dressings, or wraps. If not treating areas on hands, wash hands with soap and water after applying to remove any ointment on hands.

IV Administration:

Continuous Infusion: Diluent: Dilute in 0.9% NaCl or D5W. May be stored in polyethylene or glass containers for 24 hr following dilution. Do not store in PVC containers. Do not administer solutions that are discolored or contain particulate matter. Concentration: 0.004–0.02 mg/mL.
Rate: Infuse over 24 hr.
Y-Site Compatibility:
- alemtuzumab
- amikacin
- aminocaproic acid
- aminophylline
- amiodarone
- amphotericin B deoxycholate
- amphotericin B liposomal
- anidulafungin
- argatroban
- arsenic trioxide
- atracurium
- azithromycin
- aztreonam
- benztropine
- bivalirudin
- bleomycin
- bumetanide
- buprenorphine
- busulfan
- butorphanol
- calcium chloride
- calcium gluconate
- carboplatin
- carmustine
- caspofungin
- cefazolin
- cefotaxime
- cefotetan
- cefoxitin
- ceftazidime
- ceftolozane/tazobactam
- ceftriaxone
- cefuroxime
- chloramphenicol
- chlorpromazine
- ciprofloxacin
- cisatracurium
- cisplatin
- clindamycin
- cyclophosphamide
- cyclosporine
- cytarabine
- dacarbazine
- dactinomycin
- daptomycin
- daunorubicin
- dexamethasone
- dexmedetomidine
- dexrazoxane
- digoxin
- diltiazem
- diphenhydramine
- dobutamine
- docetaxel
- dopamine
- doxorubicin hydrochloride
- doxorubicin liposomal
- doxycycline
- droperidol
- enalaprilat
- ephedrine
- epinephrine
- epirubicin
- ertapenem
- erythromycin
- esmolol
- etoposide
- etoposide phosphate
- famotidine
- fentanyl
- fluconazole
- fludarabine
- foscarnet
- fosphenytoin
- gemcitabine
- gentamicin
- glycopyrrolate
- granisetron
- haloperidol
- heparin
- hydralazine
- hydrocortisone
- hydromorphone
- idarubicin
- ifosfamide
- imipenem/cilastatin
- insulin regular
- irinotecan
- isavuconazonium
- isoproterenol
- ketorolac
- labetalol
- letermovir
- leucovorin
- levofloxacin
- lidocaine
- linezolid
- lorazepam
- magnesium sulfate
- mannitol
- meperidine
- meropenem
- mesna
- methadone
- methotrexate
- methylprednisolone
- metoclopramide
- metoprolol
- metronidazole
- micafungin
- midazolam
- milrinone
- minocycline
- mitomycin
- mitoxantrone
- morphine
- moxifloxacin
- multivitamins
- mycophenolate
- nafcillin
- nalbuphine
- naloxone
- nicardipine
- nitroglycerin
- nitroprusside
- norepinephrine
- octreotide
- ondansetron
- oxacillin
- oxaliplatin
- oxytocin
- paclitaxel
- palonosetron
- pamidronate
- pemetrexed
- penicillin G potassium
- pentamidine
- phentolamine
- phenylephrine
- piperacillin/tazobactam
- potassium acetate
- potassium chloride
- potassium phosphates
- procainamide
- prochlorperazine
- promethazine
- propranolol
- remifentanil
- rocuronium
- sodium acetate
- sodium bicarbonate
- sodium phosphates
- succinylcholine
- sufentanil
- tedizolid
- theophylline
- thiotepa
- tigecycline
- tirofiban
- tobramycin
- topotecan
- vancomycin
- vasopressin
- vecuronium
- verapamil
- vinblastine
- vincristine
- vinorelbine
- voriconazole
- zidovudine
- zoledronic acid
Y-Site Incompatibility:
- allopurinol
- azathioprine
- cefepime
- dantrolene
- diazepam
- diazoxide
- esomeprazole
- folic acid
- gemtuzumab ozogamicin
- iron sucrose
- levothyroxine
- phenytoin

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy. Advise patient to take tacrolimus at the same time each day, with or without food, as directed. Do not skip or double up on missed doses. Do not discontinue medication without advice of health care provider. Take missed doses of extended-release capsule as soon as remembered unless >14 hr after scheduled dose; do not double doses.
Advise patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care provider before taking other medications.
Advise patient to inspect capsules with each new Rx, before taking. Contact health care provider if appearance of capsules or dose has changed.
- Advise patient to avoid grapefruit and grapefruit juice and alcohol during therapy.
- Reinforce the need for lifelong therapy to prevent transplant rejection. Review symptoms of rejection for transplanted organ and stress need to notify health care provider immediately if they occur.
- Advise patient to avoid eating raw oysters or other shellfish; make sure they are fully cooked before eating.
- Instruct patient to notify health care provider if signs/symptoms of infection (fever; sweats; chills; cough or flu-like symptoms; muscle aches; warm, red, painful areas on skin) occur.
- Instruct patient to notify health care provider if signs/symptoms of diabetes mellitus (frequent urination, ↑ thirst or hunger), neurotoxicity (vision changes, deliriums, or tremors), or PRES occur.
- Advise patient to wear protective clothing and sunscreen to avoid photosensitivity reactions.
- Advise patient to avoid exposure to chickenpox, measles, mumps, and rubella. If exposed, see health care provider for prophylactic therapy.
- Instruct patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care provider before taking any new medications.
- Advise patient of the risk of lymphoma or skin cancer with tacrolimus therapy.
Topical Instruct patient to apply ointment as directed. Advise patient to read the Medication Guide prior to starting and with each Rx renewal; new information may be available.
Advise patient not to bathe, shower, or swim right after applying; may wash off ointment. May use moisturizers with ointment. Instruct patient to check with health care provider first about products to use. If moisturizers are used, apply them after application of ointment.
Advise patients to contact health care provider if their symptoms do not improve after 6 wk of therapy, if their symptoms worsen, or if they develop a skin infection.
- Instruct patient to use ointment only on areas of skin with atopic dermatitis.
- Advise patient to stop using the ointment when the signs/symptoms of atopic dermatitis go away.
- Advise patient to limit sun exposure during treatment.
- Advise patient of the risk of using topical tacrolimus during pregnancy.
- Inform patient of the risk of lymphoma or skin cancer with topical tacrolimus therapy.
- Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected, avoid breastfeeding during therapy, and discuss family planning with health care provider before starting therapy. May impair male and female fertility. Encourage female transplant recipients and women fathered by male transplant recipients to enroll in the Transplantation Pregnancy Registry International that monitors outcomes of women exposed to tacrolimus by calling 1-877-955-6877 or visiting https://www.transplantpregnancyregistry.org/.

Evaluation/Desired Outcomes ⬆ ⬇

Prevention of transplanted organ rejection.
Improvement in signs/symptoms of atopic dermatitis.

US Brand Names ⬆ ⬇

tacrolimus (oral, IV): Astagraf XL, Envarsus XR, Prograf,

tacrolimus (topical): Protopic

Canadian Brand Names ⬆ ⬇

tacrolimus (oral, IV): Advagraf, Envarsus PA

Code ⬆

NDC Code

0078- Novartis Pharmaceuticals Corporation
- 0078-1399-
  - 0078-1399-07- 5 kg in 1 BAG (0078-1399-07)

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0416- Tacrolimus
  - 0168-0416-30- 1 TUBE in 1 CARTON (0168-0416-30) / 30 g in 1 TUBE

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0416- Tacrolimus
  - 0168-0416-60- 1 TUBE in 1 CARTON (0168-0416-60) / 60 g in 1 TUBE

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0416- Tacrolimus
  - 0168-0416-99- 1 TUBE in 1 CARTON (0168-0416-99) / 100 g in 1 TUBE

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0417- Tacrolimus
  - 0168-0417-30- 1 TUBE in 1 CARTON (0168-0417-30) / 30 g in 1 TUBE

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0417- Tacrolimus
  - 0168-0417-60- 1 TUBE in 1 CARTON (0168-0417-60) / 60 g in 1 TUBE

0168- E. Fougera & Co. a division of Fougera Pharmaceuticals Inc.
- 0168-0417- Tacrolimus
  - 0168-0417-99- 1 TUBE in 1 CARTON (0168-0417-99) / 100 g in 1 TUBE

0378- Mylan Pharmaceuticals Inc.
- 0378-2045- Tacrolimus
  - 0378-2045-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2045-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-2046- Tacrolimus
  - 0378-2046-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2046-01)

0378- Mylan Pharmaceuticals Inc.
- 0378-2047- Tacrolimus
  - 0378-2047-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (0378-2047-01)

0469- Astellas Pharma US, Inc.
- 0469-0607- Prograf
  - 0469-0607-73- 1 BOTTLE in 1 CARTON (0469-0607-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE

0469- Astellas Pharma US, Inc.
- 0469-0617- Prograf
  - 0469-0617-73- 1 BOTTLE in 1 CARTON (0469-0617-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE

0469- Astellas Pharma US, Inc.
- 0469-0657- Prograf
  - 0469-0657-73- 1 BOTTLE in 1 CARTON (0469-0657-73) / 100 CAPSULE, GELATIN COATED in 1 BOTTLE

0469- Astellas Pharma US, Inc.
- 0469-1230- Prograf
  - 0469-1230-50- 50 PACKET in 1 CARTON (0469-1230-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET

0469- Astellas Pharma US, Inc.
- 0469-1330- Prograf
  - 0469-1330-50- 50 PACKET in 1 CARTON (0469-1330-50) / 1 GRANULE, FOR SUSPENSION in 1 PACKET

0469- Astellas Pharma US, Inc.
- 0469-3016- Prograf
  - 0469-3016-01- 10 AMPULE in 1 BOX (0469-3016-01) / 1 mL in 1 AMPULE

0781- Sandoz Inc
- 0781-2102- Tacrolimus
  - 0781-2102-01- 100 CAPSULE in 1 BOTTLE (0781-2102-01)

0781- Sandoz Inc
- 0781-2103- Tacrolimus
  - 0781-2103-01- 100 CAPSULE in 1 BOTTLE (0781-2103-01)

0781- Sandoz Inc
- 0781-2104- Tacrolimus
  - 0781-2104-01- 100 CAPSULE in 1 BOTTLE (0781-2104-01)

0904- Major Pharmaceuticals
- 0904-6623- Tacrolimus
  - 0904-6623-61- 100 BLISTER PACK in 1 CARTON (0904-6623-61) / 1 CAPSULE in 1 BLISTER PACK

0904- Major Pharmaceuticals
- 0904-6624- Tacrolimus
  - 0904-6624-61- 100 BLISTER PACK in 1 CARTON (0904-6624-61) / 1 CAPSULE in 1 BLISTER PACK

0904- Major Pharmaceuticals
- 0904-7097- Tacrolimus
  - 0904-7097-61- 100 BLISTER PACK in 1 CARTON (0904-7097-61) / 1 CAPSULE in 1 BLISTER PACK

12838- Astellas Pharma Inc.
- 12838-1230-
  - 12838-1230-9- 6000 GRANULE, FOR SUSPENSION in 1 BOX (12838-1230-9)

12838- Astellas Pharma Inc.
- 12838-1330-
  - 12838-1330-9- 3000 GRANULE, FOR SUSPENSION in 1 BOX (12838-1330-9)

16714- NORTHSTAR RX LLC
- 16714-098- tacrolimus
  16714-098-01- 100 CAPSULE in 1 BOTTLE (16714-098-01)

16714- NORTHSTAR RX LLC
- 16714-099- tacrolimus
  - 16714-099-01- 100 CAPSULE in 1 BOTTLE (16714-099-01)

16714- NORTHSTAR RX LLC
- 16714-100- tacrolimus
  - 16714-100-01- 100 CAPSULE in 1 BOTTLE (16714-100-01)

16729- Accord Healthcare Inc.
- 16729-041- Tacrolimus
  - 16729-041-01- 100 CAPSULE in 1 BOTTLE (16729-041-01)

16729- Accord Healthcare Inc.
- 16729-042- Tacrolimus
  - 16729-042-01- 100 CAPSULE in 1 BOTTLE (16729-042-01)

16729- Accord Healthcare Inc.
- 16729-043- Tacrolimus
  - 16729-043-01- 100 CAPSULE in 1 BOTTLE (16729-043-01)

16729- Accord Healthcare Inc.
- 16729-421- Tacrolimus
  - 16729-421-01- 1 TUBE in 1 CARTON (16729-421-01) / 100 g in 1 TUBE

16729- Accord Healthcare Inc.
- 16729-421- Tacrolimus
  - 16729-421-10- 1 TUBE in 1 CARTON (16729-421-10) / 30 g in 1 TUBE

16729- Accord Healthcare Inc.
- 16729-421- Tacrolimus
  - 16729-421-12- 1 TUBE in 1 CARTON (16729-421-12) / 60 g in 1 TUBE

16729- Accord Healthcare Inc.
- 16729-422- Tacrolimus
  - 16729-422-01- 1 TUBE in 1 CARTON (16729-422-01) / 100 g in 1 TUBE

16729- Accord Healthcare Inc.
- 16729-422- Tacrolimus
  - 16729-422-10- 1 TUBE in 1 CARTON (16729-422-10) / 30 g in 1 TUBE

16729- Accord Healthcare Inc.
- 16729-422- Tacrolimus
  - 16729-422-12- 1 TUBE in 1 CARTON (16729-422-12) / 60 g in 1 TUBE

38779- Medisca Inc.
- 38779-2698-
  - 38779-2698-0- .5 g in 1 VIAL, GLASS (38779-2698-0)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-3- 5 g in 1 VIAL, GLASS (38779-2698-3)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-4- 25 g in 1 VIAL, GLASS (38779-2698-4)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-5- 100 g in 1 VIAL, GLASS (38779-2698-5)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-6- 1 g in 1 VIAL, GLASS (38779-2698-6)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-7- .25 g in 1 VIAL, GLASS (38779-2698-7)

38779- Medisca Inc.
- 38779-2698-
  38779-2698-9- .1 g in 1 VIAL, GLASS (38779-2698-9)

43353- Aphena Pharma Solutions - Tennessee, LLC
- 43353-317- Tacrolimus
  43353-317-09- 9000 CAPSULE in 1 BOTTLE, PLASTIC (43353-317-09)

43817- Panacea Biotec Limited
- 43817-421- Tacrolimus
  - 43817-421-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (43817-421-01)

43817- Panacea Biotec Limited
- 43817-422- Tacrolimus
  - 43817-422-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (43817-422-01)

43817- Panacea Biotec Limited
- 43817-423- Tacrolimus
  - 43817-423-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (43817-423-01)

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-390- Tacrolimus
  - 45802-390-00- 1 TUBE in 1 CARTON (45802-390-00) / 30 g in 1 TUBE

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-390- Tacrolimus
  - 45802-390-01- 1 TUBE in 1 CARTON (45802-390-01) / 60 g in 1 TUBE

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-390- Tacrolimus
  - 45802-390-02- 1 TUBE in 1 CARTON (45802-390-02) / 100 g in 1 TUBE

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-700- Tacrolimus
  - 45802-700-00- 1 TUBE in 1 CARTON (45802-700-00) / 30 g in 1 TUBE

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-700- Tacrolimus
  - 45802-700-01- 1 TUBE in 1 CARTON (45802-700-01) / 60 g in 1 TUBE

45802- Padagis Israel Pharmaceuticals Ltd
- 45802-700- Tacrolimus
  - 45802-700-02- 1 TUBE in 1 CARTON (45802-700-02) / 100 g in 1 TUBE

47848- Teva Czech Industries s.r.o
- 47848-018-
  - 47848-018-01- 1 kg in 1 CARTON (47848-018-01)

47848- Teva Czech Industries s.r.o
- 47848-018-
  47848-018-02- 1 kg in 1 CARTON (47848-018-02)

47848- Teva Czech Industries s.r.o
- 47848-018-
  47848-018-05- 1 kg in 1 CARTON (47848-018-05)

47848- Teva Czech Industries s.r.o
- 47848-018-
  47848-018-11- 1 kg in 1 CARTON (47848-018-11)

49629- Rottendorf Pharma GmbH
- 49629-020-
  49629-020-99- 1 BAG in 1 DRUM (49629-020-99) / 1 BAG in 1 BAG / 95000 TABLET in 1 BAG

49629- Rottendorf Pharma GmbH
- 49629-021-
  49629-021-99- 1 BAG in 1 DRUM (49629-021-99) / 1 BAG in 1 BAG / 95000 TABLET in 1 BAG

49629- Rottendorf Pharma GmbH
- 49629-022-
  49629-022-99- 1 BAG in 1 DRUM (49629-022-99) / 1 BAG in 1 BAG / 36000 TABLET in 1 BAG

50090- A-S Medication Solutions
- 50090-5581- tacrolimus
  50090-5581-0- 90 CAPSULE in 1 BOTTLE (50090-5581-0)

50090- A-S Medication Solutions
- 50090-5596- Tacrolimus
  - 50090-5596-0- 90 CAPSULE in 1 BOTTLE (50090-5596-0)

51079- MylanInstitutional Inc.
- 51079-028- Tacrolimus
  - 51079-028-20- 100 BLISTER PACK in 1 CARTON (51079-028-20) / 1 CAPSULE in 1 BLISTER PACK (51079-028-01)

51079- MylanInstitutional Inc.
- 51079-817- Tacrolimus
  - 51079-817-20- 100 BLISTER PACK in 1 CARTON (51079-817-20) / 1 CAPSULE in 1 BLISTER PACK (51079-817-01)

51079- MylanInstitutional Inc.
- 51079-818- Tacrolimus
  - 51079-818-20- 100 BLISTER PACK in 1 CARTON (51079-818-20) / 1 CAPSULE in 1 BLISTER PACK (51079-818-01)

51187- Hisun Pharmaceutical (Hangzhou) Co., Ltd.
- 51187-0006-
  - 51187-0006-1- 1 kg in 1 DRUM (51187-0006-1)

51434- CMIC CMO CO., LTD.
- 51434-1230-
  51434-1230-9- 6000 GRANULE, FOR SUSPENSION in 1 BOX (51434-1230-9)

51434- CMIC CMO CO., LTD.
- 51434-1330-
  51434-1330-9- 3000 GRANULE, FOR SUSPENSION in 1 BOX (51434-1330-9)

51927- Professional Compounding Centers of America dba PCCA
- 51927-0092-
  51927-0092-0- 1 kg in 1 CONTAINER (51927-0092-0)

52076- Chunghwa Chemical Synthesis & Biotech. Ltd
- 52076-6222-
  52076-6222-1- 1 kg in 1 DRUM (52076-6222-1)

52076- Chunghwa Chemical Synthesis & Biotech. Ltd
- 52076-6222-
  52076-6222-2- 5 kg in 1 DRUM (52076-6222-2)

52076- Chunghwa Chemical Synthesis & Biotech. Ltd
- 52076-6222-
  52076-6222-3- 50 kg in 1 DRUM (52076-6222-3)

52928- Joyang Laboratories
- 52928-006-
  52928-006-01- .5 kg in 1 DRUM (52928-006-01)

52972- CKD Bio Corporation
- 52972-0040-
  52972-0040-0- 600 g in 1 CAN (52972-0040-0)

55111- Dr. Reddy's Laboratories Limited
- 55111-525- Tacrolimus
  55111-525-01- 1 BOTTLE in 1 CARTON (55111-525-01) / 100 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-525- Tacrolimus
  - 55111-525-05- 1 BOTTLE in 1 CARTON (55111-525-05) / 500 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-525- Tacrolimus
  - 55111-525-30- 1 BOTTLE in 1 CARTON (55111-525-30) / 30 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-525- Tacrolimus
  - 55111-525-78- 10 BLISTER PACK in 1 CARTON (55111-525-78) / 10 CAPSULE in 1 BLISTER PACK (55111-525-79)

55111- Dr. Reddy's Laboratories Limited
- 55111-526- Tacrolimus
  - 55111-526-01- 1 BOTTLE in 1 CARTON (55111-526-01) / 100 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-526- Tacrolimus
  - 55111-526-05- 1 BOTTLE in 1 CARTON (55111-526-05) / 500 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-526- Tacrolimus
  - 55111-526-30- 1 BOTTLE in 1 CARTON (55111-526-30) / 30 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-526- Tacrolimus
  - 55111-526-78- 10 BLISTER PACK in 1 CARTON (55111-526-78) / 10 CAPSULE in 1 BLISTER PACK (55111-526-79)

55111- Dr. Reddy's Laboratories Limited
- 55111-527- Tacrolimus
  - 55111-527-01- 1 BOTTLE in 1 CARTON (55111-527-01) / 100 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-527- Tacrolimus
  - 55111-527-05- 1 BOTTLE in 1 CARTON (55111-527-05) / 500 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-527- Tacrolimus
  - 55111-527-30- 1 BOTTLE in 1 CARTON (55111-527-30) / 30 CAPSULE in 1 BOTTLE

55111- Dr. Reddy's Laboratories Limited
- 55111-527- Tacrolimus
  - 55111-527-78- 10 BLISTER PACK in 1 CARTON (55111-527-78) / 10 CAPSULE in 1 BLISTER PACK (55111-527-79)

55154- Cardinal Health 107, LLC
- 55154-4080- Tacrolimus
  - 55154-4080-8- 2000 CAPSULE in 1 BOTTLE (55154-4080-8)

55154- Cardinal Health 107, LLC
- 55154-4168- Tacrolimus
  - 55154-4168-0- 10 BLISTER PACK in 1 BAG (55154-4168-0) / 1 CAPSULE in 1 BLISTER PACK

55486- Curia Italy S.r.l.
- 55486-1576-
  - 55486-1576-0- 50 kg in 1 DRUM (55486-1576-0)

55500- North China Pharmaceutical Huasheng Co. Ltd.
- 55500-0010-
  55500-0010-2- .5 kg in 1 CANISTER (55500-0010-2)

55500- North China Pharmaceutical Huasheng Co. Ltd.
- 55500-0010-
  55500-0010-3- 2 kg in 1 CANISTER (55500-0010-3)

59746- Jubilant Cadista Pharmaceuticals Inc.
- 59746-798- Tacrolimus
  59746-798-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-798-01)

59746- Jubilant Cadista Pharmaceuticals Inc.
- 59746-799- Tacrolimus
  - 59746-799-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-799-01)

59746- Jubilant Cadista Pharmaceuticals Inc.
- 59746-800- Tacrolimus
  - 59746-800-01- 100 CAPSULE, GELATIN COATED in 1 BOTTLE (59746-800-01)

60429- Golden State Medical Supply, Inc.
- 60429-377- Tacrolimus
  - 60429-377-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (60429-377-01)

60429- Golden State Medical Supply, Inc.
- 60429-378- Tacrolimus
  - 60429-378-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (60429-378-01)

60429- Golden State Medical Supply, Inc.
- 60429-379- Tacrolimus
  - 60429-379-01- 100 CAPSULE in 1 BOTTLE, PLASTIC (60429-379-01)

62991- LETCO MEDICAL, LLC
- 62991-3072-
  - 62991-3072-1- .1 g in 1 JAR (62991-3072-1)

62991- LETCO MEDICAL, LLC
- 62991-3072-
  62991-3072-2- .5 g in 1 JAR (62991-3072-2)

62991- LETCO MEDICAL, LLC
- 62991-3072-
  62991-3072-3- 1 g in 1 JAR (62991-3072-3)

62991- LETCO MEDICAL, LLC
- 62991-3072-
  62991-3072-4- 5 g in 1 JAR (62991-3072-4)

section name header

Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇