Proper Use

Drug information provided by: IBM Micromedex

Take this medicine exactly as directed by your doctor. Do not take more or less of it and do not take it more often than your doctor ordered. Using too much will increase the chance for side effects, while using too little may cause rejection of your transplanted organ.

This medicine comes with a Medication Guide or a patient information insert and patient instructions. Read and follow the instructions carefully. Ask your doctor if you have questions.

This medicine is always used together with other medicines. Make sure you understand when to take all of your medicines during the day. Your doctor will give you a daily plan for taking your medicines.

You may take the immediate-release capsule or oral liquid with or without food. But take it the same way each time.

If you are using the extended-release capsule:

  • Swallow the capsule whole with liquid. Do not crush, break, chew, or divide it.
  • Take the capsule every morning, preferably on an empty stomach, at least 1 hour before or at least 2 hours after a meal.
  • Do not drink alcohol with the capsule.

If you are using the extended-release tablet:

  • Take it on an empty stomach in the morning, at least 1 hour before or 2 hours after a meal, at the same time every day.
  • Swallow the tablet whole with liquid (preferably water). Do not crush, chew, or divide it.
  • Do not drink alcohol with the tablet.

If you are using the granule for oral suspension, you may take it with or without food, but you should take it the same way each time. To prepare the oral liquid:

  • Empty the contents of the packet in a glass cup filled with 1 to 2 tablespoons (15 to 30 milliliters) of room temperature water and mix. Use a metal spoon to stir the mixture. Do not use plastic.
  • Drink it right away after preparing.
  • Refill the glass cup with the same amount of water and gently swirl to mix any remaining granules to get the full dose of this medicine.
  • You may also use an oral syringe to give this medicine.
  • Do not inhale the granules or let the oral liquid come in contact with your skin or eyes. If you get the granules or the oral liquid on your skin, wash the area well with soap and water. If you get them into your eyes, rinse with water.
  • Do not save the prepared oral liquid for later use.

You should not eat grapefruit or drink grapefruit juice while you are using this medicine. Grapefruit and grapefruit juice will increase the amount of medicine in the body.

Do not stop using this medicine without first checking with your doctor. You might have to take this medicine for the rest of your life to prevent your body from rejecting the transplant.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Do not use Prograf® together with cyclosporine. Tacrolimus or cyclosporine should be stopped at least 24 hours before starting the other.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules, granules):
    • To prevent heart transplant rejection:
      • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.075 milligram per kilogram (mg/kg) of body weight per day, divided into 2 doses and taken every 12 hours. Your doctor may adjust the dose as needed.
      • Children—0.3 mg/kg per day, divided in 2 doses, given every 12 hours. Your doctor may adjust your dose as needed.
    • To prevent kidney transplant rejection:
      • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.1 to 0.2 milligram per kilogram (mg/kg) of body weight per day, divided into 2 doses and taken every 12 hours. Your doctor may adjust the dose as needed.
      • Children—0.3 mg/kg per day, divided in 2 doses, given every 12 hours.
    • To prevent liver transplant rejection:
      • Adults—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.1 to 0.15 milligram per kilogram (mg/kg) of body weight per day, divided into 2 doses and taken every 12 hours. Your doctor may adjust the dose as needed.
      • Children—Dose is based on body weight and must be determined by your doctor. The starting dose is usually 0.15 to 0.2 mg/kg of body weight per day, divided into 2 doses and taken every 12 hours.
  • For oral dosage form (extended-release capsules):
    • To prevent kidney transplant rejection:
      • Adults
        • With basiliximab, mycophenolate mofetil, and steroids—Dose is based on body weight and must be determined by your doctor. The dose is usually between 0.15 to 0.2 milligram per kilogram (mg/kg) of body weight once a day before reperfusion (return of blood flow to the blocked organ) or within 48 hours after transplant.
        • With mycophenolate mofetil and steroids—Dose is based on body weight and must be determined by your doctor. The dose is 0.1 milligram per kilogram (mg/kg) of body weight within 12 hours before reperfusion, then 0.2 mg/kg once a day at least 4 hours after pre-operation dose and within 12 hours after reperfusion.
      • Children 4 years of age and older—0.3 mg/kg of body weight given once a day within 24 hours after reperfusion. Your doctor may adjust the dose as needed.
      • Children younger than 4 years of age—Use and dose must be determined by your doctor.
  • For oral dosage form (extended-release tablets):
    • To prevent kidney transplant rejection:
      • Adults—Dose is based on body weight and must be determined by your doctor. At first, 0.14 milligram (mg) per kilogram (kg) per day. Your doctor may adjust your dose as needed and tolerated.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of Astagraf XL® and it is less than 14 hours since the regular time, take the missed dose right away. If more than 14 hours have passed since the regular time, skip the missed dose and return to your regular schedule.

If you miss a dose of Envarsus XR® and it is less than 15 hours since the regular time, take the missed dose right away. If more than 15 hours have passed since the regular time, skip the missed dose and return to your regular schedule.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.