Hecoria oral and injection

Tacrolimus may increase your risk of developing serious infection, lymphoma, or other cancers. Talk with your doctor about the risks and benefits of using this medicine.

Call your doctor right away if you have any signs of infection, such as fever, chills, body aches, skin warmth or redness, or flu symptoms.

For Prograf or Hecoria: Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

For Astragraf XL or Envarsus XR: If you are more than 14 hours late, skip the missed dose. Do not take extra medicine to make up the missed dose.

Do not receive a "live" vaccine while using tacrolimus, or you could develop a serious infection. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.

Grapefruit and grapefruit juice may interact with tacrolimus and lead to unwanted side effects. Avoid the use of grapefruit products while taking tacrolimus.

Avoid drinking alcohol. It may increase your risk of side effects.

Avoid being near people who are sick or have infections. Tell your doctor at once if you develop signs of infection.

Avoid exposure to sunlight or tanning beds. Tacrolimus can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Serious and sometimes fatal infections may occur during treatment with tacrolimus. Stop using this medicine and call your doctor right away if you have signs of infection such as: sudden weakness or ill feeling, fever, chills, sweating, sore throat, painful mouth sores, skin warmth or redness, flu symptoms, muscle aches, cough, pale skin, easy bruising, or unusual bleeding.

Also call your doctor at once if you have:

• general ill feeling, pain or swelling near your transplanted organ;

• change in your mental state, problems with speech or walking, decreased vision (may start gradually and get worse quickly);

• little or no urinating; painful or difficult urination; swelling in your feet or ankles;

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• high blood pressure--severe headache, blurred vision, pounding in your neck or ears, anxiety;

• high blood sugar--increased thirst, increased urination, hunger, fruity breath odor, nausea, loss of appetite, drowsiness, blurred vision, confusion;

• high potassium--slow heart rate, weak pulse, muscle weakness, tingly feeling;

• low magnesium or phosphate--bone pain, jerky muscle movements, muscle weakness or limp feeling, slow reflexes;

• nervous system problems--confusion, headache, vision problems, tremors, numbness and tingly feeling, seizure (convulsions); or

• signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds.

Common side effects may include:

• infections, high blood pressure, low phosphate, high potassium;

• kidney problems, urination problems;

• tremors or shaking, numbness or tingling;

• nausea, diarrhea, constipation, stomach pain;

• weakness, headache, general pain;

• sleep problems (insomnia); or

• swelling in your hands or feet.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tacrolimus can harm your kidneys. This effect is increased when you also use certain other medicines, including: antivirals, chemotherapy, injected antibiotics, medicine for bowel disorders, injectable osteoporosis medication, and some pain or arthritis medicines (including aspirin, Tylenol, Advil, and Aleve).

Many drugs can interact with tacrolimus. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

• amiodarone;

• cyclosporine;

• nelfinavir;

• sirolimus; or

• the hepatitis C medications boceprevir or telaprevir.

Many medicines can interact with tacrolimus and should not be used at the same time. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed in this medication guide. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Common side effects of Hecoria include: diabetes mellitus, infection, headache, hyperglycemia, hyperkalemia, increased blood urea nitrogen, increased serum creatinine, mental status changes, nephrotoxicity, sensation disorder, and tremor. See below for a comprehensive list of adverse effects.