You may have successfully undergone a kidney transplant and are starting a new life with new hopes. In this new journey, our main goal is to protect that precious kidney that your body has received. Tacrolimus is a very important drug that helps prevent the body from rejecting this new kidney. So, today we will talk about this drug, the correct way to use it, and the things you need to be careful about.
What really happens with this medicine?
Simply put, we all have an immune system in our bodies. It's like an army that protects a country. It's this system that protects us from diseases by fighting off enemies like germs, bacteria, and viruses that come from outside.
However, when we transplant a new organ, such as a kidney, into our body, the immune system sees it as a "foreign enemy." So, the system starts attacking the new kidney as its usual duty. We call this "organ rejection."
This medicine, called tacrolimus , works by controlling the activity of your immune system to some extent, "calming" it down. Then it stops attacking the new kidney and it starts working as if it were part of your own body.
Things to tell your doctor before taking the medicine
It is extremely important that your doctor knows your complete health history before prescribing this medication. Therefore, do not hide anything and talk openly with your doctor about these things.
- If you have diabetes .
- If you have heart disease or high blood pressure .
- If you have other problems with your immune system .
- If there is an existing infection .
- If you have other liver or kidney conditions.
- If you have recently received a vaccine or are scheduled to receive one in the future.
- If you have an allergic reaction to tacrolimus or any other medicine, food, or substance.
- If you are pregnant , trying to get pregnant , or breastfeeding .
The correct way to use this medicine
The success of this medicine depends on how correctly and consistently you take it. So follow these instructions exactly.
- Take it at the same time every day: Take this medicine at the same time every day. If it's at 8 am, take it at 8 am every day. Make this a habit.
- Take on an empty stomach: For best results, take the medicine at least one hour before or two hours after eating.
- Swallow the capsule whole: Do not break, crush, or chew the capsule. Swallow it whole with a glass of water.
- Grapefruit Juice: Do not drink grapefruit or grapefruit juice while taking this medication for any reason. It can change the way the medication is absorbed by the body and cause dangerous side effects.
- Don't stop until your doctor tells you to: No matter how well you feel, don't stop taking your medication until your doctor tells you to.
If the dosage of the medicine is increased (Overdose)
If you suspect that you have accidentally taken more than the prescribed dose, immediately go to the nearest hospital Emergency Department (ETU) . Alternatively, call the National Poisons Information Centre at the Colombo National Hospital for advice.
What if I miss a dose of medication?
It's not a good idea to miss your medication, but don't worry if you do.
Imagine you are someone who takes your pill at 8 am. You forget it. If you remember within 14 hours (i.e. before 10 pm), take the missed dose as soon as you remember. From the next day, take it as usual at 8 am.
However, if you remember more than 14 hours later (for example, at 11 pm), skip the missed dose completely. Take the next dose at the usual time, which is 8 am. Never take a double dose.
Other drugs and substances that may cause problems with this medicine
Tacrolimus is a very sensitive drug. It can interact with other medications, painkillers, vitamins, and even herbal products that you are taking. Therefore, it is essential to inform your doctor about everything you are taking, even a simple painkiller you get from a pharmacy.
Below are some of these materials. Keep in mind that this is not a complete list.
| Material type | Examples and special notes |
|---|---|
| Things you should never take | Grapefruit juice, cyclosporine, cidofovir, some antifungals (e.g. Ketoconazole, Voriconazole) |
| Things to take only on medical advice |
|
What you need to be careful about while taking the medicine
- Protection from infections: This medicine lowers your immune system, so you are more likely to get infections. This means that colds, flu, and coughs can be easily spread. Therefore, avoid crowded places and places where sick people are as much as possible. If you develop symptoms such as fever, body aches, or sore throat, do not self-medicate and inform your doctor immediately.
- Pregnancy Prevention: Avoid becoming pregnant while taking this medicine. It may be harmful to the unborn baby. Both women and men should use appropriate birth control methods as advised by their doctor.
- Cancer risk: There may be a very small increased risk of some types of cancer (especially skin cancer and lymphoma) when these immunosuppressant drugs are used long-term. This is not something to be afraid of, but something to be aware of. Your doctor will be monitoring you closely.
- Sun protection: This medication may make your skin more sensitive to sunlight. Therefore, it is important to wear long-sleeved clothing, a hat, and a good sunscreen when going out in the sun.
- Blood sugar levels: This medication may increase blood sugar levels. If you have diabetes, check your blood sugar levels frequently.
- Regular medical checkups: Do not skip any of the clinic and blood tests prescribed by your doctor. These tests are essential to monitor the levels of medication in your body and kidney function.
What side effects might I experience?
As with any medicine, tacrolimus can cause some side effects. Watch out for the following symptoms.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Allergies | Skin rash, itching, swelling of the face, lips or tongue. |
| Heart problems | Chest pain, difficulty breathing, dizziness, fast or irregular heartbeat. |
| High blood sugar | Excessive hunger, excessive thirst, frequent urination, extreme fatigue, blurred vision. |
| Kidney damage | Difficulty urinating or a change in the amount of urine you pass. |
| Nervous system problems | Headache, confusion, seizures, vision changes, tremors. |
| Signs of infection | Fever, chills , cough, sore throat. |
| Common side effects that should be reported to the doctor if they persist | |
| Digestive system problems | Constipation, diarrhea, stomach pain. |
| Insomnia | Difficulty falling asleep at night. |
| Body swelling (Edema) | Swelling in areas such as ankles, feet, and hands, sudden weight gain. |
Take-Home Message
- Take tacrolimus at the same time every day, on an empty stomach.
- Do not drink grapefruit or grapefruit juice for any reason.
- If you miss a dose, take it within 14 hours. But never take two doses at once.
- Tell your doctor about all other medications, vitamins, and herbal products you are taking.
- If you develop symptoms of infection such as fever or chills, inform your doctor immediately.
- Be sure to attend all clinic appointments and blood tests your doctor orders. Your health and safety depend on a good relationship between you and your doctor.
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