Adport (Tacrolimus)
Immunosuppressant — Calcineurin Inhibitor for Organ Transplant Rejection Prevention
Adport is a prescription immunosuppressant containing tacrolimus, a calcineurin inhibitor used primarily to prevent organ rejection following liver, kidney, or heart transplantation. It works by suppressing the activity of T-cells in the immune system, allowing the body to accept the transplanted organ. Tacrolimus requires careful dose monitoring through regular blood tests and has significant drug interactions that must be managed by a transplant specialist.
Quick Facts
Key Takeaways
- Adport (tacrolimus) is an essential immunosuppressant used to prevent organ rejection after liver, kidney, or heart transplantation.
- It requires regular blood level monitoring (trough levels) to ensure the dose is effective and safe — too low risks rejection, too high risks toxicity.
- Never switch between different tacrolimus formulations (Adport, Prograf, Advagraf, Envarsus) without your transplant specialist’s approval, as they are not interchangeable.
- Avoid grapefruit, St. John’s Wort, and many other medications that can dangerously alter tacrolimus blood levels.
- Long-term immunosuppression increases the risk of infections and certain cancers — regular follow-up care and sun protection are essential.
What Is Adport and What Is It Used For?
Adport belongs to a class of medicines known as immunosuppressants. After an organ transplant — whether it involves the liver, kidney, or heart — the body’s immune system recognizes the new organ as foreign and mounts an immune response to reject it. Without immunosuppressive therapy, the transplanted organ would be destroyed by the recipient’s immune cells, primarily T-lymphocytes. Adport is designed to prevent this rejection by carefully controlling the immune response.
The active ingredient in Adport, tacrolimus, was first discovered in 1984 from the soil bacterium Streptomyces tsukubaensis in Japan. It has since become one of the cornerstone medications in transplant medicine worldwide. Tacrolimus works by binding to an intracellular protein called FKBP-12 (FK506-binding protein), forming a complex that inhibits the enzyme calcineurin. This prevents the transcription of interleukin-2 (IL-2) and other cytokines that are essential for T-cell activation and proliferation. By blocking this pathway, tacrolimus effectively dampens the immune response against the transplanted organ.
Adport is typically used in combination with other immunosuppressive medications, such as mycophenolate mofetil (or mycophenolic acid) and corticosteroids, as part of a multi-drug immunosuppressive regimen. This combination approach allows for lower doses of each individual drug, thereby reducing the risk of side effects while maintaining effective immunosuppression. The exact combination and dosing depend on the type of organ transplanted, time since transplantation, individual patient factors, and local transplant center protocols.
In addition to preventing rejection in the immediate post-transplant period, Adport is also prescribed when a patient is experiencing ongoing organ rejection that has not been adequately controlled by previous immunosuppressive treatments. In these cases, tacrolimus may replace or be added to the existing immunosuppressive regimen to achieve better control of the immune response and preserve organ function.
Tacrolimus is available under several brand names globally, including Prograf, Advagraf, Envarsus, Modigraf, Tacni, and Dailiport. It is critical to understand that these different formulations are not interchangeable because they have different pharmacokinetic profiles — the way the body absorbs and processes the drug varies between immediate-release and prolonged-release products. Adport is an immediate-release formulation taken twice daily.
What Should You Know Before Taking Adport?
Contraindications
Adport must not be taken if you have a known allergy (hypersensitivity) to tacrolimus or any of the other ingredients in the formulation. You should also not take Adport if you are allergic to macrolide antibiotics, a class of drugs that includes erythromycin, clarithromycin, and josamycin. This is because tacrolimus shares structural similarities with macrolide compounds, and cross-reactivity can occur in sensitized individuals.
Adport must never be taken together with cyclosporine (another calcineurin inhibitor). Using both drugs simultaneously can cause severe and potentially life-threatening kidney damage and excessive immunosuppression. If you are switching from cyclosporine to tacrolimus, an appropriate washout period is required under strict medical supervision.
Warnings and Precautions
Before and during treatment with Adport, there are several important precautions to be aware of:
- Lifelong medication: You will need to take Adport every day for as long as immunosuppression is required to prevent rejection of the transplanted organ. Maintain regular contact with your transplant team.
- Regular monitoring: Your doctor will perform regular blood tests to check tacrolimus levels, kidney and liver function, blood glucose, electrolytes, blood counts, and cardiac function. This is essential to determine the appropriate dose for you.
- Herbal products: Avoid all herbal medicines and supplements, particularly St. John’s Wort (Hypericum perforatum), which can significantly reduce tacrolimus levels and increase the risk of organ rejection.
- Liver disease: If you have liver problems or a history of liver disease, inform your doctor, as this may affect how tacrolimus is metabolized and require dose adjustments.
- Gastrointestinal symptoms: Report severe abdominal pain (with or without fever, chills, nausea, or vomiting) to your doctor immediately, as this may indicate gastrointestinal perforation, a serious but known complication.
- Persistent diarrhea: Diarrhea lasting more than one day should be reported, as it can significantly alter tacrolimus absorption and blood levels, potentially requiring dose adjustment.
- Heart rhythm changes: Tacrolimus can cause QT prolongation (a change in the heart’s electrical activity). Inform your doctor if you have a history of heart rhythm disorders.
- Sun protection: Limit exposure to sunlight and UV radiation by wearing protective clothing and using high-SPF sunscreen. Immunosuppressive therapy increases the risk of skin cancers, including squamous cell carcinoma and melanoma.
- Vaccinations: Inform your doctor before receiving any vaccinations. Live vaccines are generally contraindicated while taking immunosuppressants. Your transplant team will advise on safe vaccination schedules.
- Cancer risk: Patients on tacrolimus have a higher risk of developing lymphoproliferative disorders (including lymphoma) and other malignancies due to chronic immunosuppression. Regular cancer screening is recommended.
- Thrombotic microangiopathy: Seek immediate medical attention if you develop fever, unexplained bruising (appearing as small red dots), extreme fatigue, confusion, yellowing of the skin or eyes, reduced urine output, vision loss, or seizures, as these may indicate thrombotic microangiopathy (TMA), hemolytic uremic syndrome (HUS), or thrombotic thrombocytopenic purpura (TTP).
Pregnancy and Breastfeeding
If you are pregnant, breastfeeding, think you may be pregnant, or are planning to have a baby, consult your doctor before taking Adport. Tacrolimus crosses the placenta, and studies in transplant recipients have reported an increased incidence of miscarriage among patients taking tacrolimus compared with other immunosuppressive regimens. An increased rate of preeclampsia (high blood pressure with proteinuria during pregnancy) has also been reported in kidney transplant recipients taking tacrolimus.
However, studies have not found an increased risk of major congenital malformations associated with tacrolimus use during pregnancy. Pregnancy management in transplant patients is complex and requires close collaboration between transplant specialists and obstetricians. The benefits of continued immunosuppression (to prevent organ rejection) must be carefully weighed against potential risks to the fetus.
Tacrolimus is excreted in breast milk. Because of the potential for serious adverse effects in nursing infants due to immunosuppression, breastfeeding is not recommended while taking Adport.
Driving and Operating Machinery
Do not drive or operate machinery if you experience dizziness, drowsiness, or visual disturbances after taking Adport. These neurological effects are well-documented side effects of tacrolimus, particularly at higher blood levels. The risk is greater if Adport is taken together with alcohol. You are responsible for assessing your own fitness to drive, and you should discuss any concerns with your doctor.
Important Information About Excipients
Adport capsules contain lactose monohydrate. If you have been told by your doctor that you have an intolerance to certain sugars, contact your doctor before taking this medicine. The capsules also contain less than 1 mmol (23 mg) of sodium per capsule, meaning they are essentially sodium-free.
How Does Adport Interact with Other Drugs?
Tacrolimus is primarily metabolized by the cytochrome P450 enzyme CYP3A4 in the liver and intestinal wall. It is also a substrate of the efflux transporter P-glycoprotein (P-gp). Drugs that inhibit or induce CYP3A4 and/or P-gp can significantly alter tacrolimus blood concentrations. These changes can occur rapidly after starting a new interacting medication, so frequent blood level monitoring is essential during any medication changes.
The consequences of altered tacrolimus levels are clinically severe: elevated levels can cause nephrotoxicity (kidney damage), neurotoxicity, and cardiac arrhythmias, while reduced levels can lead to acute or chronic organ rejection. Because of this narrow therapeutic index, even small changes in blood levels can have significant clinical consequences.
Major Interactions — Drugs That Increase Tacrolimus Levels
The following drugs are CYP3A4 and/or P-gp inhibitors and may significantly increase tacrolimus blood levels, requiring dose reduction and close monitoring:
| Drug Category | Examples | Clinical Effect |
|---|---|---|
| Azole antifungals | Ketoconazole, fluconazole, itraconazole, posaconazole, voriconazole, isavuconazole, clotrimazole | Strong CYP3A4 inhibition; may require 50–75% dose reduction |
| Macrolide antibiotics | Erythromycin, clarithromycin, josamycin, telithromycin | Moderate to strong CYP3A4 inhibition; significant level increases |
| HIV protease inhibitors | Ritonavir, nelfinavir, saquinavir, cobicistat | Very strong CYP3A4 inhibition; drastic level increases possible |
| HCV protease inhibitors | Telaprevir, boceprevir, glecaprevir/pibrentasvir, elbasvir/grazoprevir | Variable effects; close monitoring required throughout HCV treatment |
| Calcium channel blockers | Diltiazem, verapamil, nifedipine, nicardipine | Moderate CYP3A4 inhibition; gradual level increase |
| Proton pump inhibitors | Omeprazole, lansoprazole | May increase tacrolimus absorption; monitor levels |
| Other | Grapefruit juice, letermovir, metoclopramide, ethinylestradiol, cimetidine, amiodarone, cannabidiol | Various mechanisms of CYP3A4 inhibition or altered absorption |
Major Interactions — Drugs That Decrease Tacrolimus Levels
The following drugs are CYP3A4 inducers and may significantly reduce tacrolimus blood levels, increasing the risk of organ rejection:
| Drug Category | Examples | Clinical Effect |
|---|---|---|
| Anti-TB drugs | Rifampicin, rifabutin, isoniazid | Strong CYP3A4 induction; levels may fall to subtherapeutic range |
| Anticonvulsants | Carbamazepine, phenytoin, phenobarbital | Strong CYP3A4 induction; significant level decrease |
| Herbal products | St. John’s Wort (Hypericum perforatum), Schisandra sphenanthera extract | Strong CYP3A4/P-gp induction; can cause organ rejection |
| HIV NNRTIs | Efavirenz, etravirine, nevirapine | CYP3A4 induction; dose increase may be needed |
| Anticancer agents | Enzalutamide, apalutamide, mitotane | Strong CYP3A4 induction; substantial level reduction |
| Other | Metamizole, flucloxacillin | CYP3A4 induction or altered metabolism |
Nephrotoxic Combinations
Several drugs can worsen kidney problems or neurological side effects when taken together with tacrolimus. Inform your doctor if you are taking:
- Aminoglycoside antibiotics (e.g., gentamicin) — additive nephrotoxicity
- Amphotericin B — additive nephrotoxicity
- NSAIDs (e.g., ibuprofen) — increased risk of kidney impairment
- Antiviral agents (acyclovir, ganciclovir, cidofovir, foscarnet) — additive nephrotoxicity
- Vancomycin — additive nephrotoxicity
- Trimethoprim/sulfamethoxazole — increased risk of hyperkalemia and nephrotoxicity
Hyperkalemia Risk
Tacrolimus can increase potassium levels in the blood. Your doctor must be informed if you are taking potassium supplements, potassium-sparing diuretics (e.g., amiloride, triamterene, spironolactone), or trimethoprim, as the combination can lead to dangerously high potassium levels (hyperkalemia), which can cause cardiac arrhythmias.
Interaction with Sirolimus and Everolimus
When tacrolimus is taken together with sirolimus or everolimus (mTOR inhibitors), the risk of developing thrombotic microangiopathy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome may increase. These are serious conditions involving damage to small blood vessels and can be life-threatening. Your transplant team will carefully weigh the benefits and risks of any such combination.
Take Adport on an empty stomach or at least 1 hour before or 2–3 hours after a meal. Avoid grapefruit and grapefruit juice completely while taking Adport, as grapefruit inhibits CYP3A4 enzymes and can significantly increase tacrolimus blood levels.
What Is the Correct Dosage of Adport?
Always take Adport exactly as prescribed by your doctor. The dose is highly individualized and depends on several factors: the type of organ transplanted, your body weight, your overall health status, other immunosuppressive medications you are taking, and — most importantly — your tacrolimus blood trough levels measured through regular blood tests.
Ensure you receive the same tacrolimus medication each time you collect your prescription. Do not switch between different tacrolimus products (such as Adport, Prograf, Advagraf, or Envarsus) unless your transplant specialist has specifically approved the change. Different formulations have different release characteristics and are not bioequivalent.
Adults
The starting dose for preventing organ rejection is calculated based on body weight. Initial doses immediately after transplantation are typically within the range of:
Kidney Transplantation
Starting dose: 0.20–0.30 mg/kg/day, divided into two equal doses (every 12 hours).
Target trough levels: Typically 10–20 ng/mL in the early post-transplant period, gradually reduced to 5–15 ng/mL during maintenance therapy. Exact targets vary by transplant center protocol.
Liver Transplantation
Starting dose: 0.10–0.20 mg/kg/day, divided into two equal doses (every 12 hours).
Target trough levels: Typically 10–20 ng/mL initially, reduced to 5–15 ng/mL during maintenance. Liver transplant patients generally require lower doses because the transplanted liver metabolizes tacrolimus.
Heart Transplantation
Starting dose: 0.075–0.15 mg/kg/day, divided into two equal doses (every 12 hours).
Target trough levels: Typically 10–20 ng/mL in the early period, with gradual reduction during maintenance therapy.
Your doctor will normally reduce the dose of Adport once your condition has stabilized. The dose is titrated based on efficacy (prevention of rejection) and tolerability (avoidance of side effects), guided by regular therapeutic drug monitoring (TDM).
Children
Children generally require higher doses per kilogram of body weight than adults to achieve comparable blood levels, because pediatric patients have a faster metabolic rate for tacrolimus. The starting dose and subsequent adjustments are determined by the transplant team based on the child’s weight, organ type, and blood level monitoring.
Elderly Patients
There is currently no evidence that elderly patients require a different initial dose. However, older patients may have reduced kidney and liver function, which can affect tacrolimus clearance. Dose adjustments should be based on blood level monitoring and clinical assessment of organ function.
How to Take Adport
- Adport is taken by mouth twice daily, usually in the morning and evening, approximately 12 hours apart.
- Take on an empty stomach or at least 1 hour before or 2–3 hours after a meal for consistent absorption.
- Swallow the capsules whole with a glass of water. Do not crush, chew, or open the capsules.
- Remove capsules from the blister pack immediately before taking them.
- Do not swallow the desiccant (moisture-absorbing packet) included in the aluminum foil pouch.
- Avoid grapefruit and grapefruit juice throughout your treatment.
Missed Dose
If you forget to take a dose of Adport, do not take a double dose to make up for the missed one. Wait until the next scheduled dose and continue as normal. Missing doses increases the risk of organ rejection, so try to establish a routine and take your medication at the same times every day. If you frequently miss doses, discuss strategies with your transplant team to improve adherence.
Overdose
If you take more Adport than prescribed or if a child accidentally ingests the medication, seek immediate medical attention. Symptoms of overdose may include tremor, headache, nausea, vomiting, kidney dysfunction, and electrolyte disturbances. There is no specific antidote for tacrolimus overdose. Treatment is supportive, and hemodialysis is not effective due to tacrolimus’s high protein binding and lipophilic nature.
Stopping Adport without your doctor’s guidance can lead to acute organ rejection, which may result in loss of the transplanted organ and potentially life-threatening complications. Never discontinue your immunosuppressive therapy on your own.
What Are the Side Effects of Adport?
Because Adport suppresses the body’s immune defenses, you may be more susceptible to infections than usual. These can affect the skin, mouth, gastrointestinal tract, lungs, and urinary tract. Some infections can be serious or life-threatening, including opportunistic infections caused by bacteria, viruses, fungi, or parasites. Contact your doctor immediately if you develop signs of infection such as fever, cough, sore throat, weakness, or generally feeling unwell.
Memory loss, difficulty thinking, trouble walking, or vision loss — these may indicate progressive multifocal leukoencephalopathy (PML), a very rare but potentially fatal brain infection.
Very Common (affects more than 1 in 10 people)
- High blood sugar (hyperglycemia), diabetes mellitus
- Increased blood potassium levels (hyperkalemia)
- Difficulty sleeping (insomnia)
- Tremor (shaking), headache
- High blood pressure (hypertension)
- Abnormal liver function tests
- Diarrhea, nausea
- Kidney problems (nephrotoxicity)
Common (affects 1 in 10 to 1 in 100 people)
- Decreased blood cell counts (platelets, red or white blood cells)
- Low magnesium, phosphate, potassium, calcium, or sodium levels
- Fluid retention (edema), increased uric acid, high cholesterol and triglycerides
- Anxiety, confusion, depression, mood changes, nightmares, hallucinations
- Seizures, tingling and numbness in hands and feet, dizziness
- Increased light sensitivity, eye disorders, tinnitus (ringing in ears)
- Rapid heartbeat, reduced coronary blood flow, low blood pressure
- Shortness of breath, cough, sore throat, lung changes
- Stomach inflammation, mouth ulcers, stomach bleeding, constipation, bloating
- Liver damage, jaundice (yellowing of skin/eyes), liver inflammation
- Itching, rash, hair loss, acne, increased sweating
- Joint pain, back pain, limb pain, muscle spasms
- Reduced kidney function, decreased urine production, painful urination
- General weakness, fever, weight gain
Uncommon (affects 1 in 100 to 1 in 1,000 people)
- Blood clotting disorders, decreased counts of all blood cell types
- Dehydration, decreased blood protein or sugar
- Coma, brain hemorrhage, stroke, paralysis, speech difficulties, memory problems
- Cataracts (lens clouding), impaired hearing
- Irregular heartbeat, cardiac arrest, heart muscle disease, heart enlargement
- Blood clots (deep vein thrombosis), shock
- Difficulty breathing, asthma, intestinal obstruction
- Skin inflammation, sunburn sensitivity, joint disorders
- Inability to urinate, menstrual irregularities
- Multi-organ failure, weight loss
Rare (affects 1 in 1,000 to 1 in 10,000 people)
- Small skin hemorrhages (petechiae), increased muscle stiffness
- Deafness, fluid accumulation around the heart (pericardial effusion)
- Acute shortness of breath, pancreatic cysts
- Liver blood flow problems, increased body hair
- Thirst, reduced mobility, skin ulcers
Very Rare (affects fewer than 1 in 10,000 people)
- Muscle weakness
- Abnormal echocardiogram (heart ultrasound) results
- Liver failure, bile duct narrowing
- Painful urination with blood (hematuria)
- Increased fat tissue
- Stevens-Johnson syndrome — severe skin and mucous membrane blistering
- Toxic epidermal necrolysis — widespread skin damage and peeling
- Torsades de pointes — life-threatening heart rhythm disturbance
- Blindness
Frequency Not Known (cannot be estimated from available data)
- Opportunistic infections (bacterial, fungal, viral, protozoal) — prolonged diarrhea, fever, sore throat
- Benign and malignant tumors including lymphoma and Kaposi’s sarcoma
- Pure red cell aplasia, hemolytic anemia, febrile neutropenia
- Agranulocytosis (severe white blood cell reduction with mouth sores, fever, infection)
- Allergic and anaphylactic reactions (rash, swelling of face/lips/throat, difficulty breathing)
- Posterior reversible encephalopathy syndrome (PRES) — headache, confusion, seizures, vision disturbances
- Optic neuropathy — blurred vision, color vision changes, reduced visual field
It is important to report any suspected side effects to your healthcare provider. Adverse event reporting helps continuously monitor the benefit-risk profile of Adport and contributes to the safety of all patients taking this medication.
How Should You Store Adport?
Proper storage of Adport is essential to maintain the effectiveness and safety of the medication:
- Keep out of sight and reach of children.
- Do not use after the expiry date (EXP) printed on the packaging. The expiry date refers to the last day of that month.
- Store at or below 30°C (86°F) in the original packaging to protect from moisture.
- After opening the protective aluminum foil pouch, use all capsules within 12 months and store below 25°C (77°F).
- Take each capsule immediately after removing it from the blister pack.
- Do not swallow the desiccant (drying agent) included in the aluminum pouch.
- Do not dispose of medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer in use — this helps protect the environment.
What Does Adport Contain?
Active Ingredient
The active substance is tacrolimus (as tacrolimus monohydrate). Available strengths per hard capsule: 0.5 mg, 0.75 mg, 1 mg, 2 mg, or 5 mg.
Inactive Ingredients (Excipients)
Capsule contents: Lactose monohydrate, hypromellos (E464), croscarmellose sodium (E468), and magnesium stearate (E572).
Capsule shells vary by strength and contain gelatin, titanium dioxide (E171), and various iron oxides for coloring. Some strengths also contain sodium lauryl sulfate, sorbitan laurate, brilliant blue FCF (E133), shellac (E904), propylene glycol (E1520), and potassium hydroxide (E525).
Capsule Appearance
| Strength | Color | Markings | Size |
|---|---|---|---|
| 0.5 mg | White body, ivory cap | No marking | 14.5 mm |
| 0.75 mg | Light green, opaque | “0.75 mg” in black ink on cap | 14.5 mm |
| 1 mg | White body, light brown cap | No marking | 14.5 mm |
| 2 mg | Dark green, opaque | “2 mg” in black ink on cap | 14.5 mm |
| 5 mg | White body, orange cap | No marking | 15.8 mm |
All capsules contain a white to off-white powder. Adport capsules are packed in PVC/PE/PVDC/aluminum blisters inside a protective aluminum foil pouch containing a desiccant. Available pack sizes: 7, 10, 14, 20, 28, 30, 50, 60, 90, or 100 hard capsules. Not all pack sizes may be marketed in all countries.
Marketing Authorization Holder: Sandoz A/S, Copenhagen, Denmark.
Manufacturer: Lek Pharmaceuticals d.d., Lendava, Slovenia.
Frequently Asked Questions About Adport
Adport (tacrolimus) is an immunosuppressant used to prevent organ rejection after liver, kidney, or heart transplantation. It works by suppressing the activity of T-cells in the immune system, allowing the body to accept the transplanted organ. It may also be used to treat ongoing rejection episodes when other immunosuppressive treatments have been inadequate.
No, you should not switch between different tacrolimus products (such as Adport, Prograf, Advagraf, or Envarsus) without your transplant specialist’s explicit approval. Different formulations have different release profiles and pharmacokinetic properties, making them non-interchangeable. Unauthorized switching can lead to subtherapeutic levels (risking rejection) or supratherapeutic levels (risking toxicity).
Regular blood tests are essential to measure tacrolimus trough levels (the lowest concentration before the next dose). Tacrolimus has a narrow therapeutic index, meaning the difference between an effective dose and a toxic dose is small. Blood levels help your doctor ensure the dose prevents rejection without causing toxicity. Levels can fluctuate due to diet, other medications, infections, and changes in liver or kidney function. Additional tests monitor kidney function, liver function, blood sugar, electrolytes, and blood cell counts to detect side effects early.
No. Grapefruit and grapefruit juice must be completely avoided while taking Adport. Grapefruit contains furanocoumarins that irreversibly inhibit CYP3A4 enzymes in the intestinal wall, significantly increasing tacrolimus absorption and blood levels. This can lead to serious side effects including kidney damage (nephrotoxicity) and neurological toxicity. The effect of a single glass of grapefruit juice can last up to 72 hours.
If you miss a dose, do not take a double dose to compensate. Simply wait until your next scheduled dose and continue as normal. Missing doses can increase the risk of organ rejection, so it is important to establish a consistent daily routine. Consider setting alarms or using a pill organizer. If you frequently forget doses, speak with your transplant team about strategies to improve adherence.
Tacrolimus crosses the placenta and requires careful consideration during pregnancy. Studies in transplant recipients have reported increased rates of miscarriage and preeclampsia. However, no increased risk of major congenital malformations has been found. The decision to continue tacrolimus during pregnancy must be made jointly by the transplant team and obstetric specialists, weighing the risk of organ rejection against potential fetal effects. Breastfeeding is not recommended because tacrolimus is excreted in breast milk.
References
- European Medicines Agency (EMA). Tacrolimus – Summary of Product Characteristics. www.ema.europa.eu. Accessed January 2026.
- KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients. American Journal of Transplantation. 2009;9(Suppl 3):S1–S155. doi:10.1111/j.1600-6143.2009.02834.x
- World Health Organization. WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023. www.who.int
- Staatz CE, Tett SE. Clinical pharmacokinetics and pharmacodynamics of tacrolimus in solid organ transplantation. Clinical Pharmacokinetics. 2004;43(10):623–653. doi:10.2165/00003088-200443100-00001
- Brunet M, van Gelder T, Asberg A, et al. Therapeutic Drug Monitoring of Tacrolimus – Personalized Therapy: Second Consensus Report. Therapeutic Drug Monitoring. 2019;41(3):261–307. doi:10.1097/FTD.0000000000000640
- U.S. Food and Drug Administration (FDA). Prograf (tacrolimus) – Prescribing Information. www.fda.gov. Accessed January 2026.
- British National Formulary (BNF). Tacrolimus. bnf.nice.org.uk. Accessed January 2026.
- Vanhove T, Annaert P, Kuypers DRJ. Clinical determinants of calcineurin inhibitor disposition: a mechanistic review. Drug Metabolism Reviews. 2016;48(1):88–112. doi:10.3109/03602532.2016.1151037
About the Medical Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed physicians with expertise in clinical pharmacology, transplant medicine, and nephrology. Our editorial process follows the GRADE evidence framework, and all medical claims are supported by peer-reviewed research and international guidelines from the WHO, EMA, FDA, KDIGO, and BNF.
All content is reviewed by board-certified physicians with clinical experience in transplant medicine and immunosuppressive therapy.
Evidence Level 1A — based on systematic reviews and meta-analyses of randomized controlled trials. GRADE framework applied.
No commercial funding or pharmaceutical company sponsorship. Fully independent medical editorial content.
Content reviewed and updated regularly to reflect the latest evidence and guideline changes. Last reviewed: May 10, 2026.