A kidney transplant is a truly life-changing event. Tacrolimus is a very important medication that helps protect your new life and prevent your body from rejecting the newly transplanted kidney. You may find this medication under the brand name Envarsus. So today, let's talk about this medication, how to use it, and what you need to be careful about.
What kind of medicine is this Tacrolimus?
Simply put, this medicine works by controlling your body's immune system a bit, preventing it from thinking your new kidney is "foreign" and attacking it. Medicines that control the immune system in this way are called 'immunosuppressants'. This is essential for protecting your new kidney and ensuring it functions properly.
Things you need to tell your doctor before starting medication
When talking to your doctor about this, it's important to mention any of the conditions listed below, as this will determine the dosage and other factors you will be given.
- If you have diabetes (Diabetes Mellitus)
- If you have heart disease
- If you have high blood pressure
- If you have other immune system problems
- If there is an existing infection
- If you have kidney disease or liver disease
- 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 other medicines, foods, or dyes
- If you are pregnant, or trying to get pregnant
- If you are a breastfeeding mother
How to take the medicine? Follow these instructions exactly.
To get the most out of this medicine, it is very important to use it correctly.
1. Swallow the tablet with a glass of water .
2. Take your medicine at the same time every day . Make this a habit. It's a good idea to set an alarm on your phone.
3. Swallow the tablet whole . Never break, crush, or chew the tablet.
4. Very important: Always take this medicine in the morning on an empty stomach . That is, at least one hour before breakfast, or at least two hours after breakfast.
5. Continue taking the medicine until your doctor tells you to stop.
Very important: Do not drink grapefruit juice while taking this medication for any reason . It can severely affect the way the medication works.
What to do if you miss a dose of medication?
Imagine you are supposed to take your pill at 8 am. If you forget to take it, and you remember within 15 hours, that is, before 11 pm, take it as soon as you remember. But if it is after 15 hours, that is, after 11 pm, do not take the missed dose. Skip it altogether and take the next pill at 8 am as usual the next day. Never take a double dose.
What if I take too much medicine?
If you think you have taken more medicine than you thought, call the National Poisons Information Centre at the Colombo National Hospital immediately. Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other medications that may interact with Tacrolimus
Tacrolimus can interact with many other medications, so you should tell your doctor about all the medications you are taking, including those prescribed by your doctor, over-the-counter medications, herbal products, and vitamins.
| Drug category | Examples |
|---|---|
| Do not take these with anything. | |
| Some medications for fungal infections | fluconazole, itraconazole, ketoconazole, posaconazole, voriconazole |
| Other immune regulators | cyclosporine |
| Other medications | astemizole, cidofovir, cisapride, dronedarone, pimozide, thioridazine, ziprasidone |
| Food and drink | Grapefruit juice |
| Seek medical advice as these may react with | |
| Antibiotics | clarithromycin, erythromycin, rifampin |
| Medication for high blood pressure | diltiazem, nifedipine, verapamil |
| Medicines for gastritis | omeprazole, lansoprazole, cimetidine |
| Medicine for seizures | carbamazepine, phenobarbital, phenytoin |
| Types of Steroids | prednisone, methylprednisone |
| Herbal products | St. John's wort |
This list is not complete, so it is very important to tell your doctor about any new medications you are taking.
Things you should be careful about when taking medication
Scheduled medical tests
It is essential to attend the clinics as prescribed by your doctor. During this time, your blood levels of Tacrolimus, kidney function, and sugar levels will need to be checked regularly. Do not skip these tests.
Protect yourself from infections
This medicine reduces the activity of your immune system, so you can easily get infections. Therefore, stay away from people who have symptoms such as fever, cold, cough, and sore throat. Also, if you have any symptoms of an infection such as fever, chills, sore throat, or burning when urinating , do not self-medicate and inform your doctor immediately.
Pregnancy and family planning
This is a very important matter.
- For women: Do not become pregnant while taking this medicine. This can cause serious harm to an unborn baby. Therefore, you should use an effective form of birth control while taking this medicine and for as long as your doctor advises after you stop taking it. Talk to your doctor about this.
- For men: If you are taking this medicine, be sure to use a condom if you have sex with a woman who could become pregnant. There is a risk of harm to the baby if your partner becomes pregnant.
Cancer risk and sunlight
Taking these immune-suppressing drugs long-term may slightly increase your risk of developing certain types of cancer, such as skin cancer and lymphoma. This medicine can also make your skin more sensitive to sunlight. Therefore:
- Avoid the harsh sun as much as possible.
- If you are going to be in the sun, wear clothing that covers your skin and a wide-brimmed hat.
- Be sure to use a good sunscreen.
What are the possible side effects?
Like any medicine, Tacrolimus can cause side effects. Some of these are serious and should be reported immediately.
| Side effects that you should report to your doctor immediately | |
|---|---|
| Allergy symptoms | Skin rash, itching, swelling of the face, lips or tongue. |
| Changes in heart rate | Chest pain, difficulty breathing, dizziness, feeling like your heart is beating fast or irregularly. |
| Increased blood pressure | When the doctor checked, his blood pressure was high. |
| Symptoms of high blood sugar | More hunger, thirst, frequent urination, extreme fatigue, blurred vision. |
| Effect on the kidneys | Decreased urine output or difficulty urinating. |
| Nervous system problems | Severe headaches, confusion, seizures, vision changes, behavior changes, tremors in the limbs. |
| Numbness in the limbs | Pain, numbness, or burning in the hands or feet. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Stomach pain | Constipation or diarrhea. |
| Insomnia | Difficulty falling asleep at night. |
| Body swelling (Edema) | Swelling in areas such as ankles, feet, hands, or sudden weight gain. |
Take-Home Message
- Take Tacrolimus tablets at the same time every day, on an empty stomach.
- Do not take this medicine with grapefruit juice for any reason.
- Don't miss any clinic appointments or blood tests your doctor gives you.
- If you develop any signs of infection, such as fever or cough, inform your doctor immediately.
- Whether you are a woman or a man, be sure to use a reliable method of birth control to prevent pregnancy while taking this medicine.
- Be sure to ask your doctor before starting any new medication, herbal product, or even a vitamin.
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