Tacrolimus Capsules (Astagraf XL) are a type of calcineurin inhibitor immunosuppressant, primarily used in kidney transplant patients to prevent organ rejection.

Precautions for Taking Tacrolimus Capsules (Astagraf XL)

Strictly Follow Doctor's Instructions for Medication

Tacrolimus Capsules must be used under the guidance of a physician with experience in immunosuppressive therapy.

This drug cannot be interchangeable with other tacrolimus products, including tacrolimus extended-release tablets, tacrolimus immediate-release capsules, or tacrolimus oral suspension.

Switching between different dosage forms of tacrolimus products must be conducted under the supervision of a physician; otherwise, it may lead to graft rejection or other serious adverse reactions.

Correct Administration Method

The capsules must be swallowed whole; patients must not chew, split, or crush the capsules.

The drug should be taken with a liquid to ensure it enters the body completely.

Standardized Administration Time

Take the medication at the same time every early morning to ensure consistent drug exposure and maximize its potential efficacy.

It should be taken on an empty stomach, i.e., at least 1 hour before a meal or 2 hours after a meal.

Special Dietary Requirements

Avoid consuming grapefruit or drinking grapefruit juice, and avoid alcohol at the same time.

These foods and beverages may affect drug metabolism and increase the risk of adverse reactions.

Handling of Missed Doses

If a dose is missed, the missed dose can be taken within 14 hours after the scheduled administration time.

If more than 14 hours have passed, the patient should wait until the next morning's regular scheduled time to take the next daily dose; doubling the next dose is not allowed.

Medication Monitoring for Tacrolimus Capsules (Astagraf XL)

Monitoring Timing

Therapeutic drug monitoring is recommended for all patients receiving Tacrolimus Capsules.

During the first week after starting administration and after dose adjustments, tacrolimus whole-blood trough concentrations should be measured on at least two different days.

Blood drug concentrations should be monitored after changes in the concurrent administration of CYP3A4 inducers and/or inhibitors or cannabidiol, or after changes in renal or hepatic function.

Target Range for Trough Concentrations

Trough concentration monitoring for adult patients must follow a specific range.

For patients treated with basiliximab, mycophenolic acid, and steroids, the target range in the first month is 7–15 ng/mL.

CYP3A Inhibitors

When used in combination with potent CYP3A inhibitors, the dose of Tacrolimus Capsules needs to be reduced.

Early and frequent monitoring of tacrolimus whole-blood trough concentrations is necessary.

CYP3A Inducers

When used in combination with potent CYP3A inducers, the dose of Tacrolimus Capsules needs to be increased, and tacrolimus whole-blood trough concentrations should be monitored.