High-visibility version

Switching Medicines — the Dangers

Cases in the UK of patients being offered ADVAGRAF instead of PROGRAF, or vice versa – in error by GPs and Pharmacists, highlights the very real danger patients face if they accept a change to their medication made by anyone other than the Transplant Surgeon or Consultant Nephrologists. These days drugs are very complex, and even though one make of a drug appears to contain the same or a similar drug to another (in the given example the drug is tacrolimus) the formulations can be very different and very harmful if taken by mistake.

The lesson is clear, if the drug you are being prescribed, or handed is not identical to the drug you are used to taking – DON’T TAKE IT without getting advice from your own renal consultant. This applies even if the person is your GP, Chemist, Nurse or other Physician.

• Essential information for users and prescribers of tacrolimus medication (PDF, 81 kB)
• www.mytacrolimus.co.uk
• ESPRIT Group Consensus (PDF, 133 kB)
• Kidney Life article — Has your immunosuppressant medication changed recently? An important message for all transplant patients (PDF, 78 kB)
• ESPRIT Group Recommendations
• Renal Tsar’s Warning on Ciclosporin
• The Association of British Pharmaceutical Industries paper: Generic Medicines (PDF, 18 kB)
• Astellas’ warning on Advagraf, Prograf and Modigraf (PDF, 1.6MB)
• Automatic Generic Substitution — Clinical implications for patients (PDF, 339 kB)
• Dispensing Doctors Association Online article: Generic Substitution

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The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.