Let's learn about Tacrolimus tablets: If your doctor has prescribed this medicine

You too have had an organ transplant, such as a kidney, liver, or heart, and the doctor gave you a special medicine to keep the new organ from being rejected by your body. Most of the time, that medicine is called Tacrolimus. This is a very important medicine, and it is a medicine that needs to be used with some care. So, as your friend, I am here to tell you everything you need to know about this medicine in simple, Sinhala language that you can understand.

Simply put, what is Tacrolimus?

Think of our body's immune system as an army that protects a country. This army destroys enemies like germs and viruses that come from outside. Now, when you get a new organ transplant, this "army" in our body sees that new organ as an "enemy." Because it is something new to the body. So this army starts attacking the new organ. This is what we call "organ rejection."

Tacrolimus is a drug that calms down the activity of that "army." In medicine, we call these immunosuppressants . Simply put, this drug tells our immune system, "Don't worry, this new organ is our friend, don't attack it." So the newly transplanted organ starts working as a part of your body without any problems.

Things you need to tell your doctor before starting this medication

It is very important that your doctor is fully aware of your health condition before prescribing this medicine to you. Therefore, if you have any of the conditions listed below, be sure to tell your doctor.

• If you have diabetes .
• If you have heart disease .
• If you have high blood pressure .
• If there is another problem with the immune system.
• If you have an existing infection (even something like a fever, cold, cough).
• If you have kidney disease .
• If you have liver disease .
• If you are scheduled to receive a vaccine in the future or have recently received one.
• If you have had an allergic reaction to tacrolimus or any other medicine, food, or dye.
• If you are trying to get pregnant or are pregnant .
• If you are a mother who is breastfeeding .

It is very important for your safety to say these things without hiding them.

What is the correct way to take the medicine?

To get the most out of this medicine, you need to take it exactly as directed.

• Swallow the medicine whole with a glass of water.
• Do not take this medicine with grapefruit or grapefruit juice for any reason. This is very important. Grapefruit juice can cause dangerously high levels of Tacrolimus in the body.
• Get into the habit of taking your medicine at the same time every day. If it's at 8 am, take it at 8 am every day. This will help keep the levels of the medicine in your body consistent.
• Do not break, crush, or chew the medicine. Swallow it whole.
• You can take this medicine before or after meals. However, you should get into the habit of taking it at the same time every day. If you take it before meals, take it every day before meals. If you take it after meals, take it every day after meals.
• Continue using this medicine until your doctor tells you to stop. Do not stop suddenly.

What to do if you take too much medicine?

If you think you have taken more medicine than the prescribed dose, don't panic and take action immediately.

• If possible, go to the nearest hospital's Emergency Department (ETU) immediately.
• Alternatively, call the National Poison Information Centre at the Colombo National Hospital for advice.

What if I forget to take my medicine?

We all forget things. If you forget to take your medicine, here's what to do:

• Take the missed dose as soon as you remember.
• However, if it is almost time for your next dose when you remember (e.g., it is only a few hours away), skip the missed dose and take your next dose at the scheduled time.
• Never take a double dose to make up for the missed dose and the next dose.

Other medications that may interact with Tacrolimus

Tacrolimus can interact with many other medications. Therefore, tell your doctor about all the medications you are taking (prescription medications, over-the-counter pain relievers, vitamins, herbal remedies, and herbal supplements, such as St. John's wort). You can find more information about this in the table below.

Things you should be especially careful about when taking this medicine:

You will need to make some small changes to your lifestyle while taking Tacrolimus. These are very important for your safety.

Scheduled medical tests

Your doctor will need to see you regularly. He or she will also order regular blood tests to check your Tacrolimus levels and kidney function. Never miss these appointments and blood tests.

Protect yourself from infections

Because this medicine reduces the function of your immune system, you are more likely to develop illnesses, especially infections.

• Minimize going to crowded places as much as possible.
• Stay away from people who have illnesses like fever and cold.
• Wash your hands often with soap.
• If you develop symptoms of an infection such as fever, chills, sore throat, cough, or burning when urinating, do not self-medicate and call your doctor immediately.

Pregnancy and birth control

• Women: Getting pregnant while taking this medication can cause serious birth defects in the baby. Therefore, it is essential to use reliable birth control before starting the medication and throughout the entire time you are taking it. Talk to your doctor about this.
• Men: If you are taking this medicine, it is essential to use a condom during sex. If your partner becomes pregnant, inform your doctor immediately.

Be careful of the sun.

Tacrolimus can make your skin more sensitive to the sun and may slightly increase your risk of skin cancer.

• Avoid going out in the sun as much as possible.
• If going out in the sun, wear long-sleeved clothing, a hat, and use a good sunscreen .

Blood sugar level

This medicine may cause high blood sugar levels (hyperglycemia) . This risk is especially high if you have diabetes. Watch for symptoms such as frequent thirst, frequent urination, and blurred vision.

Side effects that may occur due to medication

Like any medicine, Tacrolimus can cause side effects. Some are serious, while others are mild. The important thing is to be aware of these symptoms and take action quickly if necessary.

How do you properly store and dispose of medication?

• Keep the medicine out of the reach of children and pets .
• Store at normal room temperature (between 20-25 degrees Celsius). Do not store in high humidity areas such as the bathroom.
• Do not use expired medicine.
• To dispose of unused or expired medications, it is best to hand them over to a hospital or pharmacy. If that is not possible, remove the medication capsules from the container, mix them with something like coffee grounds, soil, or used cat litter, place them in a well-sealed bag, and throw them in the trash.