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Indication & Dosage |
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| Oral |
| PREVENTION OF REJECTION IN LIVER GRAFT TRANSPLANT |
| Child:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Oral |
| PREVENTION OF REJECTION IN LIVER GRAFT TRANSPLANT |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Oral |
| PREVENTION OF REJECTION IN KIDNEY GRAFT TRANSPLANT |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Oral |
| FISTULISING CROHN'S DISEASE |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Intravenous |
| PREVENTION OF REJECTION IN KIDNEY GRAFT TRANSPLANT |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Intravenous |
| PREVENTION OF REJECTION IN LIVER GRAFT TRANSPLANT |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Intravenous |
| PREVENTION OF REJECTION IN LIVER GRAFT TRANSPLANT |
| Child:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Topical/Cutaneous |
| ATOPIC DERMATITIS |
| Adult:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Topical/Cutaneous |
| ATOPIC DERMATITIS |
| Child:
Initially, 0.15-0.2 mg/kg/day in 2 divided doses every 12 hr. Begin oral dose within 24 hr of transplant. Initiate therapy only when renal function has recovered. (serum concentration ≤4mg/dL). |
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| Administration |
Should be taken on an empty stomach (i.e. At least one hour before food or four hours after food). (Take on an empty stomach at least 1 hr before or 2-3 hr after meals.) |
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| Precautions |
Monitoring of blood trough serum concentrations to prevent organ rejection and to reduce drug-related toxicity. Topical: Used with caution on the face or neck, large areas of the body (not >50% of the total BSA), or areas of broken skin. Infections at the treatment site should be cleared prior to therapy. Delay use in patients with unknown cause of lymphadenopathy or acute infectious mononucleosis till resolution. Use in patients with Netherton's syndrome is not recommended. Pregnancy. |
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Potentially Life-threatening
Adverse Drug Reactions |
Systemic: Tremor, headache, paraesthesias, nausea and diarrhoea, hypertension, blood dyscrasias, leucocytosis, impaired renal function, serum electrolyte disturbances, infectious complications. Mood changes, sleep disturbances, confusion, dizziness, tinnitus, visual disturbances convulsions, alterations in glucose metabolism, ECG changes, tachycardia, myocardial hypertrophy, constipation, dyspepsia and GI haemorrhage; dyspnoea, asthma, pleural effusions; alopoecia, hirsutism, skin rash and pruritus; myalgia, spasm, leg cramps, peripheral oedema, liver dysfunction and coagulation disorders. Topical: Burning, stinging, soreness, pruritus, skin disorders, headache and flu-like symptoms. Increased incidence of malignancy. |
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| Adverse Drug Reactions |
Nephrotoxicity, neurotoxicity and anaphylactic reaction. |
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| Interactions |
Increased nephrotoxicity with ciclosporin, aminoglycosides, amphotericin B, cisplatin, NSAIDs, vancomycin, co-trimoxazole, aciclovir, ganciclovir. Increased risk of hyperkalemia with potassium-sparing diuretics. Increased plasma concentrations and toxicity with azole antifungals, calcium-channel blockers, cimetidine, danazol, HIV-protease inhibitors, macrolide antibacterials and metoclopramide. Antacids, rifampin, rifabutin, casofungin, phenytoin, phenobarbital and carbamazepine decrease tacrolimus plasma concentrations. Concurrent admin of sirolimus and tacrolimus decrease levels of both. |
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