Tacrolimus

Question 1

Tacrolimus MHRA

Answer 1

Prescribed by brand only.

Question 2

Tacrolimus cautions

Answer 2

UV light
Increased risk of infections
Neurotoxicity
QT PROLONGATION
Malignancies

Question 3

What food can increase the concentration of tacrolimus

Answer 3

Pomegranate jucie and pomelo

Question 4

SE of tacrolimus

Answer 4

Tremor
Alopecia
Cardiovascular (Hypertension)
Renal insufficiency
Oncological (skin cancer)
Lipids (hyperlipidaemia)
Insulin dependent diabetes
Magnesium wastage
Uric acid elevation
Seizures

Question 5

Tacrolimus monitoring

Answer 5

When using systematically
- BP
- ECG
- Fasting blood glucose
- Haematological
- Neurological
- Coagulation parameters
- Hepatic and renal function

Question 6

Tacrolimus in preg and breast feeding

Answer 6

Avoid unless the benefits outweigh risk
Crosses placenta and there is a risk of premature delivery, intrauterine growth restriction and hyperkalemia

Question 7

Tacrolimus counselling

Answer 7

• Avoid excessive exposure to UV light (use SPF)
• May affect the performance of skilled tasks
• Patients must not receive immunisation with live vaccines
• Avoid a high potassium diet and grapefruit juice
• Switching between brands is associated with toxicity and graft rejection - prescribe by brand