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Tacrolimus

About your medicine

All patients who have a kidney transplant need to take drugs called immuno-suppressants. Tacrolimus belongs to a group of medicines called immuno-suppressants. As the word immuno-suppressant suggests, the function of these drugs is to suppress the immune system, the body’s natural defence system. The aim is to dampen down the immune system enough to stop it rejecting the transplant kidney while still keeping it active enough to fight infections.

Tacrolimus is also taken for autoimmune diseases for example minimal change disease. It is used to try and improve kidney function and to dampen down the disease, stopping it from causing any further damage to the body.

Tacrolimus is only available from your doctor.

There are several different brands of tacrolimus. Prograf® was the first to be introduced. There are now several others for example Adoport ®and Advagraf®. You should not switch between brands without the advice of the transplant or renal unit, and a check is needed to make sure that the blood levels of the drug are kept at the right level for you.

You should NOT be vaccinated with some vaccines whilst receiving tacrolimus. (Vaccines are injections that can be given to help prevent you from catching some diseases, for example, polio). For vaccines you can and cannot have, see the vaccine page.

Taking your medicine

The capsules should be removed from the blister immediately before taking and swallowed whole with water. The capsules are best taken one hour before a meal or two hours afterwards ie on an empty stomach.

The total daily dose that you are asked to take should be divided and taken in two doses, 12 hours apart (Prograf® and Adoport®), or once daily (Advagraf®).

You should AVOID grapefruit and grapefruit juice for one hour before taking tacrolimus because it will affect the amount of tacrolimus in your body.

Take the capsules as your doctor recommended, never change the dose yourself. If you do not take the tacrolimus you will lose your new kidney or cause a flare up of your disease.

If you forget to take a dose, or accidentally take an extra dose, tell your doctor. You will need to have regular blood samples taken to check that the dose of tacrolimus is right for you; too much can be harmful to your kidney. When you come to have a blood test do not take your morning dose until after you have had your blood taken.

Unwanted effects

Tacrolimus can cause side effects in some people. The most common side effects with tacrolimus include trembling, headaches, feeling sick, and ‘pins and needles’ in your arms and legs. You should inform your doctor if you suffer from any of these. Tacrolimus can also damage your kidneys if your blood levels are too high.

You are more likely to develop infections whilst receiving immuno-suppressant therapy and any infections may be worse than normal, so you should report any signs of infection to your doctor.

Some other drugs may cause problems with tacrolimus; these include erythromycin, clarithromycin, fluconazole, rifampicin and miconazole. Some herbal remedies may also cause problems, including St John’s wort. This is not a full list so be sure to check with your doctor or pharmacist before taking any other medication along with tacrolimus.

You should avoid sunbathing and use a sunblock in sunny weather. You are recommended to see your doctor about regular skin checks and cervical smears for women. This is because you are more likely to develop skin or cervical cancers which may not be serious if noticed early.

Storing your medicine

Store the capsules in their original packet in a cool, dry place away from children. Capsules should not be taken if they have been out of the aluminium outer wrapper for longer than twelve months. Only remove the capsules from the blister immediately before taking.

You should NOT eat the sachet of silica gel contained within the aluminium wrapper.

All medicines may cause side effects in some people. If you think that you are suffering from a side effect of one of your medicines it is important NOT to stop taking the medicine, but see your doctor who will be able to change that medicine for one which will suit you better.

Always take your medicines as directed by your doctor and only stop them on the advice of your doctor

Do not throw out any expired or unwanted medicine by flushing them down the toilet or throwing them away. Take them to your local pharmacy which will dispose of them for you.


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.

NKF Controlled Document No. 78: Tacrolimus written: 22/04/2000 last reviewed: 01/10/2016