Prograf and Advagraf XL (Tacrolimus)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Prograf and Advagraf XL Used For?
Prograf and Advagraf XL contain tacrolimus, an immunosuppressive medicine that helps protect your transplanted organ from being rejected by your body’s immune system.
Primary Uses
Used to prevent your body from attacking and rejecting a transplanted liver, kidney, lung, or heart. May also be prescribed if other anti-rejection medicines are not working effectively.
How It Works
Your body naturally recognizes a transplanted organ as foreign and tries to attack it like it would attack germs. Prograf and Advagraf XL stop this immune system attack, allowing your new organ to function properly.
Important: It’s crucial to take this medicine regularly as prescribed to prevent organ rejection, even if you feel well.
How to Take Prograf and Advagraf XL
Your doctor will calculate your exact dose based on your weight, age, and medical condition. Regular blood and urine tests will help determine if dose adjustments are needed.
Dosage Instructions
PROGRAF capsules: Take twice daily (morning and evening). ADVAGRAF XL capsules: Take once daily in the morning. Swallow capsules whole with plenty of water. Take on an empty stomach – at least 1 hour before or 2-3 hours after meals. Do not use grapefruit juice. Never change your dose on your own.
What If You Miss a Dose?
If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take a double dose to make up for a missed dose. If you’ve missed more than one dose, contact your doctor or pharmacist for guidance.
Important: Never double your dose, even if you missed a previous dose. Contact your doctor if you’re unsure what to do.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Tiredness and lack of energy
- Stomach upset, nausea, vomiting, loss of appetite
- Diarrhea and stomach cramps
- Tremor (shaking)
- Headache
- Feeling depressed
- Sleeping difficulties
- Blurred vision or light sensitivity
- Muscle cramps, tenderness, or weakness
Seek immediate medical attention if you experience:
- Signs of allergic reaction (rash, swelling, breathing problems)
- Fever
- Diabetes or increased blood sugar
- Swelling, numbness, or tingling in hands and feet
- Constant flu-like symptoms or signs of infection
- Unusual bleeding or bruising
- High blood pressure
- Heart problems (palpitations, abnormal rhythms, chest pain)
- New lumps, moles, or changes to existing moles
- Swelling of eyelids, hands, or feet
- Changes in urination or kidney problems
- Yellowing of skin or eyes (jaundice)
- Symptoms of anemia (shortness of breath, tiredness, dizziness)
- Seizures (fits)
- Buzzing or ringing in ears, hearing difficulties
Important Warnings
Prograf and Advagraf XL suppress your immune system, which increases certain health risks that you need to be aware of.
Who Should Not Take Prograf and Advagraf XL
Do not use if you are allergic to tacrolimus, macrolide antibiotics (like erythromycin, clarithromycin), or any ingredients in the medicine. Do not use if you are currently receiving cyclosporin immunosuppressive therapy. ADVAGRAF XL and PROGRAF are not interchangeable.
Medical Conditions to Discuss
Tell your doctor about all medical conditions and if you are taking any other medicines, vitamins, or supplements. Your doctor needs to monitor you carefully for potential complications.
Pregnancy and Breastfeeding
Tell your doctor immediately if you become pregnant while taking this medicine. Discuss with your doctor if you are breastfeeding or planning to breastfeed. Check with your doctor if you are using oral contraceptives.
Cancer Risk: This medicine increases your risk of skin cancer and other cancers. Always protect yourself from the sun with sunscreen, hat, and protective clothing.
Drug Interactions
Many medicines can interfere with Prograf and Advagraf XL. Always tell your doctor and pharmacist about all medicines you’re taking.
Grapefruit Warning: Do not use grapefruit juice as it interferes with how this medicine works in your body.
- Antifungal medicines and antibiotics (ketoconazole, fluconazole, erythromycin, clarithromycin, rifampicin)
- HIV medicines (ritonavir, efavirenz, nevirapine)
- Hepatitis C medicines (telaprevir, boceprevir)
- Stomach medicines (omeprazole, lansoprazole, cimetidine)
- Heart and blood pressure medicines (nifedipine, diltiazem, verapamil, amiodarone)
- Cholesterol medicines (statins)
- Epilepsy medicines (carbamazepine, phenytoin, phenobarbital)
- Pain medicines (ibuprofen, metamizole)
- Steroids (prednisolone, methylprednisolone)
- St. John’s wort herbal preparations
- Potassium supplements and certain diuretics
- Blood thinners and diabetes medicines
Alcohol & Driving
This medicine may affect your ability to drive safely and can interact with alcohol.
Alcohol
Tell your doctor if you drink alcohol. Alcohol may interact with this medicine.
Driving and Operating Machinery
Prograf and Advagraf XL may cause visual disturbances or nervous system problems. Do not drive or operate machinery if you experience these effects. Be careful until you know how this medicine affects you.
Storage
Store PROGRAF capsules in a cool, dry place below 30°C. Store ADVAGRAF XL capsules in a cool, dry place below 25°C. Keep capsules in blister packs until ready to use. Use PROGRAF capsules within 3 months of opening the aluminum wrapper. Use ADVAGRAF XL capsules within 12 months of opening the aluminum wrapper. Keep medicines in a locked cupboard at least 1.5 meters above ground, away from children. Do not store in bathrooms or cars where heat and dampness can damage the medicine.
Overdose Information
If you think you have taken too much Prograf or Advagraf XL, seek immediate medical attention even if you feel fine. Call the Poisons Information Centre at 13 11 26, contact your doctor, or go to the nearest hospital emergency department. You may need urgent medical care even without obvious symptoms.
Frequently Asked Questions
This medicine works continuously to prevent organ rejection. Your doctor will monitor your blood levels regularly to ensure the medicine is working effectively and adjust your dose as needed.
No, these capsules should be taken on an empty stomach – at least 1 hour before or 2-3 hours after meals. Food reduces how well your body absorbs the medicine.
Never stop taking this medicine without your doctor’s guidance. Stopping suddenly could cause your body to reject your transplanted organ, which can be life-threatening.
Tell your doctor if you drink alcohol, as it may interact with this medicine. Your doctor will advise you about alcohol consumption while on this treatment.
If it’s almost time for your next dose, skip the missed dose and take your next dose at the regular time. Never take a double dose. If you’ve missed multiple doses, contact your doctor or pharmacist.
Your doctor needs to monitor the levels of medicine in your blood and check how well your new organ is functioning. This helps ensure you’re getting the right dose for your body.
No, ADVAGRAF XL and PROGRAF are not interchangeable. Only take the specific formulation your doctor has prescribed and never switch without medical supervision.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.