Trusted, medically reviewed health information • Not a substitute for medical advice
Medically Verified MonographPrescription OnlyClass: Calcineurin Inhibitors

Tacrolimus

Generic Name: Tacrolimus

Common Brand Names: Prograf, Astagraf XL, Envarsus XR
Dosage Form:Capsule, Injection, Ointment
Route:Oral, Intravenous, Topical
Pregnancy Category:C
Last Reviewed:9/21/2026

Seek Urgent Medical Attention If:

You experience severe allergic reaction symptoms (swelling of the face, lips, tongue, or throat causing difficulty breathing), severe rash with skin peeling, sudden intense chest pain, or symptoms of overdose. Call emergency medical services immediately.

Uses & Medical Indications

Prophylaxis of organ rejection

Medical Conditions Treated:

Organ transplant rejection, Atopic dermatitis

Dosage & Administration Guidelines

Adult Dosage

0.1-0.2 mg/kg/day orally in two divided doses

Pediatric Dosage

0.15-0.3 mg/kg/day orally in two divided doses

Elderly / Geriatric Considerations

Use lower end of adult dosage range

Maximum Dose Limit

Based on target trough concentrations

Renal Impairment:

Use lowest recommended dose

Hepatic Impairment:

Reduce dose in severe impairment

Side Effects & Safety Warnings

Common Side Effects

Tremor, headache, diarrhea, hypertension, nausea

Serious Adverse Reactions

Nephrotoxicity, neurotoxicity, increased risk of infections

Contraindications:

Hypersensitivity to tacrolimus

Important Warnings & Precautions:

Increased risk of malignancies and infections

Interactions (Drugs, Food & Alcohol)

Drug-Drug Interactions:

CYP3A inhibitors/inducers

Food & Dietary Interactions:

Grapefruit juice increases levels

Alcohol Interaction Warning:

May increase side effects

Pregnancy & Breastfeeding Safety

Pregnancy Safety

Use only if benefit justifies risk

Breastfeeding / Lactation

Present in milk, avoid

Patient Counseling & Practical Advice

How to Take:

Take consistently with/without food, avoid grapefruit

What to Do if You Miss a Dose:

Take as soon as remembered if within 14 hours

Recommended Monitoring & Lab Tests:

Whole blood trough concentrations, renal function

Trustworthy Sources & Medical Review

Content for Tacrolimus was synthesized and fact-checked against standardized regulatory monographs, official pharmacopoeias, and national health authorities:

  • Central Drugs Standard Control Organization (CDSCO) — National List of Essential Medicines
  • World Health Organization (WHO) — Model List of Essential Medicines 23rd List
  • Indian Pharmacopoeia Commission (IPC) — Indian Pharmacopoeia Drug Monographs
  • National Health Service (NHS) — Medicines A to Z Clinical Guidelines
Reviewer Credentials: PharmD, Clinical PharmacologistLast Reviewed Date: 9/21/2026

The information provided on this website is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.