Tacromus 1 Capsule

✔️ Side Effects | Tacromus

• Loose motion, nausea
• Increased blood sugar, diabetes mellitus, and increased potassium in the blood
• Sleeping difficulties
• Headache
• Increase in blood pressure
• Kidney problems

✔️ Talk to your doctor if

• If you have liver problems
• If you have stomach pain with chills, fever, nausea, or vomiting
• If you have heart disease
• Stopping your treatment with Tacrolimus may increase the chances of rejection of your transplanted organ
• Do not stop your medication without your doctor’s permission

✔️ Interaction | Tacromus

• Antifungal medicines like Ketoconazole, Fluconazole, Itraconazole, Voriconazole, Clotrimazole, and Isavuconazole, and antibiotics like Erythromycin, Clarithromycin, and Rifampicin
• Medicines used in HIV/ AIDS (e,.g. Ritonavir, Nelfinavir, Saquinavir)
• Nilotinib and Imatinib (used to treat certain cancers)
• Mycophenolic acid, which is used to suppress the immune system to prevent organ transplant rejection
• Medicines for stomach ulcer and acid reflux (e.g., Omeprazole, Lansoprazole, or Cimetidine)
• Medicines used to treat nausea and vomiting (e.g, Metoclopramide)
• Ibuprofen (used to treat fever, pain), Amphotericin B (used to treat bacterial infections), or antivirals (used to treat viral infections,s e.g., Aciclovir)
• This medicine has food interactions with grapefruit juice. Avoid grapefruit (also as juice) while on treatment with Tacrolimus, since it can affect its levels in the blood and effectiveness.

✔️ General Administration | Tacromus

Start oral therapy when the patient can tolerate it.

Initial dose timing:

• Liver, heart, lung transplants: ≥ 6 hours post-transplant
• Kidney transplant: Within 24 hours, but delay until renal function recovers
• Administer every 12 hours; adjust dose based on whole-blood trough levels.

✔️ Adult Dosing & Target Trough Levels

Kidney Transplant

With azathioprine: 0.2 mg/kg/day

With MMF/IL-2 receptor antagonist: 0.1 mg/kg/day

Trough levels:

Months 1–3: 7–20 ng/mL

Months 4–12: 5–15 ng/mL

With MMF/IL-2 RA (Months 1–12): 4–11 ng/mL

Liver Transplant

With corticosteroids: 0.10–0.15 mg/kg/day

Trough (Months 1–12): 5–20 ng/mL

Heart Transplant

With azathioprine or MMF: 0.075 mg/kg/day

Trough:

Months 1–3: 10–20 ng/mL

Month ≥4: 5–15 ng/mL

Lung Transplant

With azathioprine or MMF: 0.075 mg/kg/day

Trough:

Months 1–3: 10–15 ng/mL

Months 4–12: 8–12 ng/mL

Note: In lung transplant patients—especially those with cystic fibrosis—oral bioavailability may be reduced; higher doses may be required. Monitor levels closely.

✔️ Pediatric Dosing & Target Trough Levels

Kidney: 0.3 mg/kg/day → 5–20 ng/mL (Months 1–12)

Liver: 0.15–0.2 mg/kg/day → 5–20 ng/mL (Months 1–12)

Heart: 0.3 mg/kg/day → 5–20 ng/mL (Months 1–12)

Lung: 0.3 mg/kg/day

Weeks 1–2: 10–20 ng/mL

Week 2–Month 12: 10–15 ng/mL

✔️ Pregnancy & Lactation

Pregnancy: May cause fetal harm; counsel on potential risks.

Lactation: Use only if benefits outweigh risks.

✔️ Key Warnings & Precautions

Not interchangeable with extended-release tacrolimus products (risk of medication errors).

New-onset diabetes: Monitor blood glucose.

Nephrotoxicity: Dose reduction may be needed; caution with nephrotoxic drugs.

Neurotoxicity/PRES: Monitor neurologic symptoms; reduce or discontinue if needed.

Hyperkalemia: Monitor potassium.

Hypertension: Monitor BP and drug interactions.

IV anaphylaxis risk: Observe during injection.

Avoid with sirolimus in liver/heart transplants.

Myocardial hypertrophy: Consider dose reduction/discontinuation.

Avoid live vaccines.

Pure red cell aplasia and thrombotic microangiopathy (HUS/TTP) may occur—monitor and manage promptly.

✔️ Storage:

Store below 30°C, dry place, away from light and moisture. Keep out of the reach of children