TACROLIMUS (ADVAGRAF)
PATIENT INFORMATION LEAFLET
 TACROLIMUS (Advagraf) is a drug that is used as an anti rejection drug for those who have undergone kidney or liver transplant. It works by reducing the activity of the immune system (the body’s defence system)
 TACROLIMUS (Advagraf) suppresses the immune system by inhibiting T cells. This reduces production of cytokines such as TNF
 that are known to play a part in causing Rheumatoid Arthritis.
 TACROLIMUS (Advagraf) has been used to effectively treat Rheumatoid
Arthritis both on it’s own, and in combination with methotrexate .
 TACROLIMUS (Advagraf) is taken in tablet form at a dose of 3 mg once a day. This can be reduced if you develop side effects.
 TACROLIMUS (Advagraf) is not a pain killer or anti-inflammatory. You should not stop your painkillers or anti-inflammatory drugs unless your doctor advises otherwise.
 TACROLIMUS (Advagraf) usually takes at least 4-6 weeks to start working.
POSSIBLE SIDE EFFECTS OF TACROLIMUS (ADVAGRAF)
 Around 1 in 5 patients may experience sickness, diarrhoea, or heartburn.
Occasionally this may mean that you may have to take a lower dose or stop taking TACROLIMUS (Advagraf).
 Around 1 in 5 patients may experience headaches or muscular aches and pains.
 Approximately 1 in 5 patients will have raised kidney function tests while taking TACROLIMUS (Advagraf). You may have to stop taking the drug temporarily. Around 3% of patients studied had to stop TACROLIMUS due to abnormal kidney function tests. In most of these cases kidney function eventually returned to normal.
 About 1 in 40 patients experience tremor, which resolves if the dose is lowered or stopped.
 Development of a rash may mean that you are allergic to TACROLIMUS
(Advagraf)
– you should stop taking the drug and consult your doctor.
 Your risk of developing infections may be increased. If you develop bruising, fever, sore throat or any other new symptoms after starting
TACROLIMUS (Advagraf), consult your doctor.
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PTO

 If you come into skin contact with someone with chickenpox or shingles, or if you develop chickenpox or shingles you need to contact you doctor immediately or follow the instructions on the chicken pox and shingles leaflet. Contact the Rheumatology Department on the number below, if you do not have a leaflet.
Chickenpox & Shingles can be life threatening when taking
Tacrolimus (Advagraf).
 You will need to avoid certain immunisations that use live vaccines.
Always check with your doctor before undergoing any immunisation. Flu vaccine and pneumovax are safe and recommended.
 While taking TACROLIMUS (Advagraf) you will need to attend for special blood tests that monitor kidney, liver function, and immune cell counts. Initially this will be two weekly, then monthly. You should not be taking TACROLIMUS (Advagraf) unless you attend for blood tests.
 Some drugs should not be taken with TACROLIMUS (Advagraf), always check with your doctor or pharmacist before starting any new drugs.
 You should not plan pregnancy while taking TACROLIMUS (Advagraf) and should be using an effective form of contraception if you are sexually active. TACROLIMUS (Advagraf) will make the oral contraceptive pill less effective. If you become pregnant while taking the drug, inform your doctor immediately. You should not breast feed while taking TACROLIMUS
(Advagraf).
 Alcohol does not need to be avoided while taking TACROLIMUS
(Advagraf), but you must not exceed 14 units / week if you are female or
21 units / week if you are male.

You should not take St. John’s Wort with TACROLIMUS (Advagraf).
General enquiries: 01592 648193
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Updated April 2010 Version 1 due for review April 2011