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Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

This medicine does not cause different types of side effects or problems in children than it does in adults, although some side effects may occur more or less often than they do in adult patients.

Geriatric

There is no specific information comparing the use of tacrolimus in the elderly with the use in other age groups. Tacrolimus is not expected to cause different side effects or problems in older people than it does in younger adults. However, older patients may need lower doses of tacrolimus.

Pregnancy

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aceclofenac
• Acemetacin
• Alclofenac
• Amikacin
• Amiloride
• Amiodarone
• Apazone
• Bacillus of Calmette and Guerin Vaccine, Live
• Basiliximab
• Benoxaprofen
• Bromfenac
• Bufexamac
• Carbamazepine
• Carprofen
• Caspofungin
• Cisplatin
• Clometacin
• Clonixin
• Colchicine
• Cyclosporine
• Darunavir
• Dexketoprofen
• Dibekacin
• Diclofenac
• Diflunisal
• Dipyrone
• Droxicam
• Efavirenz
• Etodolac
• Etofenamate
• Etravirine
• Felbinac
• Fenbufen
• Fenoprofen
• Fentiazac
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Gentamicin
• Ibuprofen
• Indomethacin
• Indoprofen
• Isoxicam
• Itraconazole
• Kanamycin
• Ketoprofen
• Ketorolac
• Lornoxicam
• Measles Virus Vaccine, Live
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Mumps Virus Vaccine, Live
• Nabumetone
• Naproxen
• Nefazodone
• Neomycin
• Netilmicin
• Niflumic Acid
• Nimesulide
• Oxaprozin
• Oxyphenbutazone
• Phenobarbital
• Phenylbutazone
• Phenytoin
• Pirazolac
• Piroxicam
• Pirprofen
• Poliovirus Vaccine, Live
• Posaconazole
• Propyphenazone
• Proquazone
• Rifabutin
• Rifampin
• Rotavirus Vaccine, Live
• Rubella Virus Vaccine, Live
• Sirolimus
• Smallpox Vaccine
• Spironolactone
• St John's Wort
• Streptomycin
• Sulindac
• Suprofen
• Tenidap
• Tenoxicam
• Tiaprofenic Acid
• Tobramycin
• Tolmetin
• Triamterene
• Typhoid Vaccine
• Varicella Virus Vaccine
• Voriconazole
• Yellow Fever Vaccine
• Zomepirac

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Amprenavir
• Chloramphenicol
• Clarithromycin
• Clotrimazole
• Dalfopristin
• Danazol
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Diltiazem
• Erythromycin
• Fluconazole
• Fosphenytoin
• Ketoconazole
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate
• Metoclopramide
• Metronidazole
• Mibefradil
• Nelfinavir
• Nevirapine
• Nifedipine
• Quinupristin
• Rifapentine
• Ritonavir
• Saquinavir
• Schisandra sphenanthera
• Telithromycin
• Theophylline

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Cancer—Tacrolimus can make this condition worse.

• Chickenpox (including recent exposure) or
• Herpes zoster (shingles)—The risk of severe disease affecting other parts of the body may be increased.

• Diabetes mellitus (sugar diabetes)—Tacrolimus can increase the amount of sugar in the blood.

• Hepatitis or
• Kidney disease or
• Liver disease—Tacrolimus can have harmful effects on the kidney in patients with these conditions; a lower dose of tacrolimus may be needed in patients with these conditions.

• Hyperkalemia (high amount of potassium in the blood) or
• Nervous system problems—Tacrolimus can make these conditions worse.

• Infection—Tacrolimus decreases the body's ability to fight infection.

DR601851

Nov. 1, 2009

Source: Drug Information provided by: Micromedex

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