For most people, taking a new medication may mean switching up your lifestyle a bit and that includes the foods you eat. A food-drug interaction means that a specific nutrient or compound within the food changes the way your body metabolizes the medication, and this can either enhance or reduce the dose your body gets, according to Johns Hopkins Medicine. The potential results: an increased risk of side effects, many of which can be dangerous, or the drug not working as it was intended.
Before introducing a medication, ask your pharmacist about any food interactions, including with alcohol, and any adjustments you may have to make to your diet.
What is Tacrolimus?
Tacrolimus is in a class of medications called immunosuppressants. It works by decreasing the activity of the immune system to prevent it from attacking the transplanted organ. Tacrolimus is used together with other medicines to prevent the body from rejecting a transplanted organ (eg, kidney, liver, heart, or lung). This medicine may be used with steroids, azathioprine, basiliximab, or mycophenolate mofetil. Tacrolimus belongs to a group of medicines known as immunosuppressive agents.
When a patient receives an organ transplant, the body’s white blood cells will try to get rid of (reject) the transplanted organ. Tacrolimus works by suppressing the immune system to prevent the white blood cells from trying to get rid of the transplanted organ.
Tacrolimus is a very strong medicine. It can cause side effects that can be very serious, such as kidney problems. It may also decrease the body’s ability to fight infections. You and your doctor should talk about the benefits of this medicine as well as the risks of using it.
This medicine is available only with your doctor’s prescription.
This product is available in the following dosage forms:
- Tablet, Extended Release
- Capsule
- Capsule, Extended Release
- Granule
How is Tacrolimus used?
Tacrolimus comes as a capsule, granules for oral suspension (to be mixed with liquid), an extended-release (long-acting) capsule, and an extended-release tablet to take by mouth. The immediate-release capsules (Prograf) and oral suspension (Prograf) are usually taken twice a day (12 hours apart). You may take the immediate-release capsules and oral suspension either with or without food, but be sure to take it the same way each time. The extended-release capsules (Astagraf XL) or extended-release tablets (Envarsus XR) are usually taken every morning on an empty stomach at least 1 hour before breakfast or at least 2 hours after breakfast. Take tacrolimus at the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tacrolimus exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking the granules for oral suspension, you will need to mix it with room temperature water before use. Place 1 to 2 tablespoons (15 to 30 milliliters) of water into a cup containing the granules. Mix the contents and then immediately take the mixture by mouth from the cup or with an oral syringe; do not save the mixture for a later time. The granules will not completely dissolve. If any of the mixtures remains, add 1 to 2 tablespoons (15 to 30 milliliters) of water to the mixture and immediately take it.
Swallow the extended-release capsules and extended-release tablets whole with water; do not split, chew, or crush them. Do not open the immediate-release capsules,
Your doctor will monitor you carefully and adjust your dose as needed. Talk to your doctor often about how you are feeling during your treatment. Ask your doctor if you have any questions about how much tacrolimus you should take.
Different tacrolimus products release the medication differently in your body and cannot be used interchangeably. Only take the tacrolimus product prescribed by your doctor and do not switch to a different tacrolimus product unless your doctor says that you should.
Tacrolimus can only prevent rejection of your transplant as long as you are taking the medication. Continue to take tacrolimus even if you feel well. Do not stop taking tacrolimus without talking to your doctor.
How long does tacrolimus stay in your system?
The half-life of tacrolimus is about 2 days. This means that half of a dose of tacrolimus is removed from your body after 2 days.
What food should I avoid while on tacrolimus?
Generally, you should avoid drinking or eating the following foods and other high potassium foods while on tacrolimus:
- Grapefruit or Grapefruit Juice
- Bananas
- Oranges or orange juice
- Potatoes
- Soda (Fresca)
- Spinach
- Dried fruits (raisins, apricots)
- Beans
- Potatoes
- Winter squash (acorn, butternut)
- Broccoli
- Beet greens.
- Avocado.
Does alcohol affect tacrolimus levels?
Studies have shown that when used together, alcohol may increase the rate of release of tacrolimus and/or adversely alter the pharmacokinetic properties, effectiveness, and safety. A flushing syndrome (alcohol intolerance) has been reported in patients treated with tacrolimus.
What are the side effects of tacrolimus?
Tacrolimus may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
• headache
• diarrhea
• constipation
• nausea
• vomiting
• heartburn
• stomach pain
• loss of appetite
• difficulty falling asleep or staying asleep
• dizziness
• weakness
• back or joint pain
• burning, numbness, pain, or tingling in the hands or feet
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
• decreased urination
• pain or burning on urination
• shortness of breath, hives, rash, or itching
• pale skin, shortness of breath, or fast heartbeat
• tiredness; weight gain; swelling of the arms, hands, feet, ankles, or lower legs; or shortness of breath
• unusual bleeding or bruising
• seizures, vision changes, headache, confusion, or uncontrollable shaking of a part of the body
• coma (loss of consciousness for a period of time)
Tacrolimus may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
