{"ok":true,"entry":{"slug":"tacrolimus","kind":"medication","name":"tacrolimus","aliases":["Prograf","Protopic"],"brands_sg":["Prograf","Advagraf","Protopic","Tacrolimus Sandoz","Tacrocin"],"class":"calcineurin-inhibitor immunosuppressant","tags":["other"],"use_for":"healthhub: preventing rejection after organ transplant","use_after":"healthhub: on an empty stomach, taken consistently","use_duration":null,"take_with":"healthhub: water · not grapefruit or pomelo","pros":["healthhub: also used in ra and lupus nephritis","register: capsules, prolonged-release caps, ointment","sg label: protopic ointment is for atopic dermatitis"],"cons":["healthhub: raises blood sugar, potassium and bp","healthhub: tremor, headache, hair loss, acne, infection","healthhub: rare heart-rhythm and skin cancer warnings"],"dose_note":"no fixed milligram ceiling appears on the singapore labels. the sg product information for prograf (national drug formulary) states “Oral tacrolimus therapy should commence at 0.10 – 0.20 mg/kg/day for liver transplantation and at 0.15 – 0.30 mg/kg/day for kidney transplantation administered as two divided doses” and adds that these figures “are intended to act as a guideline” and “should be adjusted according to individual patient requirements”, with blood-level monitoring. for the skin the ceiling is a frequency, not a dose: protopic's sg label runs 0.1% ointment “twice a day” until lesions clear, children start “twice a day for up to three weeks” then drop to once a day, and its maintenance indication follows “a maximum of 6 weeks treatment” of twice-daily ointment. in singapore the prescriber sets the dose.","dosage":null,"ul_status":null,"sg_class":"prescription-only","cautions":["allergy to macrolide antibiotics such as erythromycin or clarithromycin (healthhub)","high blood pressure, diabetes, kidney or liver problems (healthhub)","qt prolongation — healthhub asks that heart-rhythm changes be declared","live vaccines — healthhub: these must be avoided, and vaccination plans declared"],"clashes":[{"src":["hh_tac_avoid"],"food":true,"note":"healthhub: grapefruit may interact and increase the risk of side-effects","with":"grapefruit and pomelo"},{"src":["hh_tac_prec"],"note":"healthhub asks that these be declared before starting","with":"st john's wort and other supplements or herbal remedies"},{"src":["hh_tac_prec"],"note":"healthhub: live vaccinations must be avoided while on tacrolimus","with":"live vaccinations"}],"sources":[{"id":"hsa_register","url":"https://data.gov.sg/datasets/d_767279312753558cbf19d48344577084/view","label":"HSA — Listing of Registered Therapeutic Products (data.gov.sg d_767279312753558cbf19d48344577084); cached at /tmp/hsa_all.json and filtered locally (not re-fetched), 26 tacrolimus rows","quote":"PROGRAF CAPSULES 5 mg SIN09650P · Advagraf Prolonged Release Hard Capsules 5 mg SIN14135P · PROTOPIC OINTMENT 0.1% SIN12524P · TACROLIMUS SANDOZ CAPSULE 1 MG SIN15674P · TACROCIN 5 SIN16157P — all 26 rows “Prescription Only”","accessed":"2026-08-27"},{"id":"hh_tac_uses","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tacrolimus","label":"HealthHub (Pharmaceutical Society of Singapore / MOH) — Tacrolimus: what is this medication for","quote":"Tacrolimus works by suppressing the immune system. It is used to prevent organ rejection in solid organ transplants, as well as prevent graft-versus-host disease … auto-immune diseases such as rheumatoid arthritis and lupus nephritis","accessed":"2026-08-27"},{"id":"hh_tac_howto","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tacrolimus","label":"HealthHub — Tacrolimus: how should I take or use this medication","quote":"This medicine should be taken on an empty stomach – either 1 hours before food, or 2 hours after … Take Tacrolimus consistently either with or without food. For capsules: Swallow the capsule whole, do not crush or chew.","accessed":"2026-08-27"},{"id":"hh_tac_prec","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tacrolimus","label":"HealthHub — Tacrolimus: what precautions should I take","quote":"You are allergic to any antibiotic belonging to the subgroup of macrolide antibiotics (e.g. Erythromycin, Clarithromycin) … supplements, traditional medications and herbal remedies e.g. St John’s Wort … you must avoid any live vaccinations.","accessed":"2026-08-27"},{"id":"hh_tac_side","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tacrolimus","label":"HealthHub — Tacrolimus: common and serious side effects","quote":"Increased blood sugar … Increased potassium and/or reduced magnesium in your blood … Increased blood pressure … Tremors, headache … Hair loss; Acne (pimples) … QT prolongation … Cancer (blood or predominantly skin cancers)","accessed":"2026-08-27"},{"id":"hh_tac_avoid","url":"https://www.healthhub.sg/medication-devices-and-treatment/medications/tacrolimus","label":"HealthHub — Tacrolimus: what food or medication should I avoid","quote":"Avoid taking grapefruit and pomelo when you are taking this medicine as grapefruit may interact with your medicine and increase the risk of side-effects.","accessed":"2026-08-27"},{"id":"ndf_tac_prograf_dose","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin09650p/","label":"Singapore National Drug Formulary — PROGRAF CAPSULES 5 mg [SIN09650P], Posology and Method of Administration","quote":"Oral tacrolimus therapy should commence at 0.10 – 0.20 mg/kg/day for liver transplantation and at 0.15 – 0.30 mg/kg/day for kidney transplantation administered as two divided doses.","accessed":"2026-08-27"},{"id":"ndf_tac_prograf_guide","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin09650p/","label":"Singapore National Drug Formulary — PROGRAF [SIN09650P], dosage guidance","quote":"The dosage recommendations given below for oral and intravenous administration are intended to act as a guideline. Prograf doses should be adjusted according to individual patient requirements.","accessed":"2026-08-27"},{"id":"ndf_tac_protopic_dose","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12524p/","label":"Singapore National Drug Formulary — PROTOPIC OINTMENT 0.1% [SIN12524P], Posology","quote":"Treatment should be started with Protopic® 0.1% twice a day and treatment should be continued until clearance of the lesion … Treatment should be started twice a day for up to three weeks","accessed":"2026-08-27"},{"id":"ndf_tac_protopic_ind","url":"https://www.ndf.gov.sg/about-drugs/product-information/sin12524p/","label":"Singapore National Drug Formulary — PROTOPIC OINTMENT 0.1% [SIN12524P], Indication","quote":"Treatment of moderate to severe atopic dermatitis for the prevention of flares … who have had an initial response to a maximum of 6 weeks treatment of twice daily tacrolimus ointment","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:33.302383+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}