Prograf 1mg Hard Capsules
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3. How to take Prograf®
PACKAGE LEAFLET: INFORMATION FOR THE USER PROGRAF® 1mg hard capsules
(tacrolimus)
Your medicine is available as the above name but will be referred to as Prograf throughout this leaflet.
This product is available in multiple strengths and all strengths will be referred to throughout this leaflet.
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1. What Prograf® is and what it is used for
2. What you need to know before you take Prograf®
3. How to take Prograf®
4. Possible side effects
5. How to store Prograf®
6. Contents of the pack and other information
1. What Progral® is and what it is used for
Prograf® belongs to a group of medicines called immunosuppressants. Following your organ transplant (e.g. liver, kidney, heart), your body's immune system will try to reject the new organ.
Prograf® is used to control your body's immune response enabling your body to accept the transplanted organ.
Prograf® is often used in combination with other medicines that also suppress the immune system.
You may also be given Prograf® for an ongoing rejection of your transplanted liver, kidney, heart or other organ or if any previous treatment you were taking was unable to control this immune response after your transplantation.
2. What you need to know before you take Prograf®__
Do not take Progral®
- If you are allergic (hypersensitive) to tacrolimus or any of the other ingredients of Prograf® (listed in section 6).
- If you are allergic (hypersensitive) to any antibiotic belonging to the subgroup of macrolide antibiotics (e.g. erythromycin, clarithromycin, josamycin).
Warnings and precautions
Talk to your doctor or pharmacist before taking Prograf®
- You will need to take Prograf® every day as long as you need immunosuppression to prevent rejection of your transplanted organ. You should keep in regular contact with your doctor.
- Whilst you are taking Prograf® your doctor may want to carry out a number of tests (including blood, urine, heart function, visual and neurological tests) from time to time. This is quite normal and will help your doctor to decide on the most appropriate dose of Prograf® for you.
- Please avoid taking any herbal remedies, e.g. St. John's wort (Hypericum perforatum) or any other herbal products as this may affect the effectiveness and the dose of Prograf® that you need to receive. If in doubt please consult your doctor prior to taking any herbal products or remedies.
- If you have liver problems or have had a disease which may have affected your liver, please tell your doctor as this may affect the dose of Prograf® that you receive.
- If you feel strong abdominal pain accompanied or not with other symptoms, such as chills, fever, nausea or vomiting.
- If you have diarrhoea for more than one day, please tell your doctor, because it might be necessary to adapt the dose of Prograf® that you receive.
- If you have an alteration of the electrical activity of your heart called “QT prolongation”.
- Limit your exposure to sunlight and UV light whilst taking Prograf® by wearing appropriate protective clothing and using a sunscreen with a high sun protection factor. This is because of the potential risk of malignant skin changes with immunosuppressive therapy.
- If you need to have any vaccinations, please inform your doctor beforehand. Your doctor will advise you on the best course of action.
- Patients treated with Prograf® have been reported to have an increased risk of developing lymphoproliferative disorders (see section 4). Ask your doctor for specific advice on these disorders.
Other medicines and Prograf®
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription and herbal remedies.
Prograf® must not be taken with ciclosporin.
Prograf® blood levels can be affected by other medicines you take, and blood levels of other medicines can be affected by taking Prograf® which may require interruption, an increase or a decrease in Prograf® dose. In particular, you should tell your doctor if you are taking or have recently taken medicines with active substances like:
- antifungal medicines and antibiotics (particularly so-called macrolide antibiotics) used to treat infections e.g. ketoconazole, fluconazole, itraconazole, voriconazole, clotrimazole, erythromycin, clarithromycin, josamycin, and rifampicin
- HIV protease inhibitors (e.g. ritonavir, nelfinavir, saquinavir), used to treat HIV infection
- HCV protease inhibitors (e.g. telaprevir, boceprevir), used to treat hepatitis C infection
- medicines for stomach ulcer and acid reflux (e.g. omeprazole, lansoprazole or cimetidine)
- antiemetics, used to treat nausea and vomiting (e.g. metoclopramide)
- magnesium-aluminium-hydroxide (antacid), used to treat heartburn
- hormone treatments with ethinylestradiol (e.g. the oral contraceptive pill) or danazol
- medicines for high blood pressure or heart problems such as nifedipine, nicardipine, diltiazem and verapamil
- anti-arrhythmic medicines (amiodarone) used to control arrhythmia (uneven beating of the heart)
- medicines known as “statins” used to treat elevated cholesterol and triglycerides
- the anti-epileptic medicines phenytoin or phenobarbital
- the corticosteroids prednisolone and methylprednisolone
- the anti-depressant nefazodone
- St. John's Wort (Hypericum perforatum)
Tell your doctor if you are taking or need to take ibuprofen, amphotericin B, or antivirals (e.g. aciclovir). These may worsen kidney or nervous system problems when taken together with Prograf®.
Your doctor also needs to know if you are taking potassium supplements or potassium-sparing diuretics (e.g., amiloride, triamterene, or spironolactone), certain pain killers (so-called NSAIDs, e.g. ibuprofen), anticoagulants, or oral medication for diabetic treatment, while you take Prograf®.
If you need to have any vaccinations, please inform your doctor beforehand.
Prograf® with food and drink
You should generally take Prograf® on an empty stomach or at least 1 hour before or 2 to 3 hours after a meal. Grapefruit and grapefruit juice should be avoided while taking Prograf®.
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Prograf® is excreted into breast milk. Therefore you should not breast-feed whilst receiving Prograf®.
Driving and using machines
Do not drive or use any tools or machines if you feel dizzy or sleepy, or have problems seeing clearly after taking Prograf®. These effects are more frequently observed if Prograf® is taken in conjunction with alcohol use.
Prograf® contains lactose and lecithin (soya)
Prograf® contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
The printing ink used on Prograf® capsules 0.5 mg and 1 mg contains soya lecithin. If you are allergic to peanut or soya, talk to your doctor to determine whether you should use this medicine.
Always take Prograf® exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.
Make sure that you receive the same tacrolimus medicine every time you collect your prescription, unless your transplant specialist has agreed to change to a different tacrolimus medicine.
This medicine should be taken twice a day. If the appearance of this medicine is not the same as usual, or if dosage instructions have changed, speak to your doctor or pharmacist as soon as possible to make sure that you have the right medicine.
The starting dose to prevent the rejection of your transplanted organ will be determined by your doctor calculated according to your body weight. Initial doses just after transplantation will generally be in the range of
0.075 - 0.30 mg per kg body weight per day depending on the transplanted organ.
Your dose depends on your general condition and on which other immunosuppressive medication you are taking. Regular blood tests by your doctor will be required to define the correct dose and to adjust the dose from time to time. Your doctor will usually reduce your Prograf® dose once your condition has stabilised. Your doctor will tell you exactly how many capsules to take and how often.
Prograf® is taken orally twice daily, usually in the morning and evening. You should generally take Prograf® on an empty stomach or at least 1 hour before or 2 to 3 hours after the meal. The capsules should be swallowed whole with a glass of water. Take the capsules immediately following removal from the blister. Avoid grapefruit and grapefruit juice while taking Prograf®. Do not swallow the desiccant contained in the foil wrapper.
If you take more Prograf® than you should
If you have accidentally taken too much Prograf® see your doctor or contact your nearest hospital emergency department immediately.
If you forget to take Prograf®
Do not take a double dose to make up for forgotten individual doses.
If you have forgotten to take your Prograf® capsules, wait until it is time for the next dose, and then continue as before.
If you stop taking Prograf®
Stopping your treatment with Prograf® may increase the risk of rejection of your transplanted organ.
Do not stop your treatment unless your doctor tells you to do so.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
