Реферат: Такролимус
Revisions to the PRECAUTIONS and ADVERSE REACTIONS sections. A new Patient’s Information leaflet is added to the PROGRAF Capsules labeling
PRECAUTIONS
*Drugs That May Decrease Tacrolimus Blood Concentrations:
Anticonvulsants Antibiotics
carbamazepine rifabutin
phenobarbital rifampin
phenytoin
Herbal Preparations
St. John’s Wort
*This table is not all inclusive.
St. John’s Wort (hypericum perforatum) induces CYP3A4 and P-glycoprotein. Since tacrolimus is a substrate for CYP3A4, there is the potential that the use of St. John’s Wort in patients receiving Prograf could result in reduced tacrolimus levels.
ADVERSE REACTIONS
Post Marketing
The following have been reported: increased amylase including pancreatitis, hearing loss including deafness, leukoencephalopathy, thrombocytopenic purpura, hemolytic-uremic syndrome, acute renal failure, Stevens-Johnson syndrome, stomach ulcer, glycosuria, and cardiac arrhythmia and gastroenteritis.
Patient Information
PROGRAF
(tacrolimus capsules)
Read this important information before you start using PROGRAF [PRO-graf] and each time you refill your prescription. This summary does not take the place of talking with your transplant team.
Talk with your transplant team if you have any questions or want more information about PROGRAF. You can also visit the Fujisawa Internet site at www.fujisawa.com.
What Is PROGRAF?
PROGRAF is a medicine that slows down the body’s immune system. For this reason, it works as an anti-rejection medicine.
PROGRAF helps patients who have had a liver or kidney transplant protect their new organ and prevent it from being rejected by the body.
How Does PROGRAF Protect My New Organ?
The body’s immune system protects the body against anything that it does not recognize as part of the body. For example, when the immune system detects a virus or bacteria it tries to get rid of it to prevent infection. When a person has a liver or kidney transplant, the immune system does not recognize the new organ as a part of the body and tries to get rid of it, too. This is called "rejection." PROGRAF protects your new organ by slowing down the body’s immune system.
Who Should Not Take PROGRAF?
Do not take PROGRAF if you are allergic to any of the ingredients in PROGRAF. The active ingredient is tacrolimus. Ask your doctor or pharmacist about the inactive ingredients.
Tell your transplant team about all your health conditions, including kidney and/or liver problems. Discuss with your transplant team the use of any other prescription and non- prescription medications, including any herbal or over-the-counter remedies that you may take while on Prograf. In very rare cases you may not be able to take Prograf.
Tell your transplant team if you are pregnant, planning to have a baby or are breastfeeding. Talk with your transplant doctor about possible effects PROGRAF could have on your child. Do not nurse a baby while taking PROGRAF since the medicine will be in the breast milk.
How Should I Take PROGRAF?
PROGRAF can protect your new kidney or liver only if you take the medicine correctly.
Your new organ needs around-the-clock protection so your body does not reject it. The success of your transplant depends a great deal upon how well you help PROGRAF do its job. Here is what you can do to help.
Take PROGRAF exactly as prescribed
It is important to take PROGRAF capsules exactly as your transplant team tells you to.
PROGRAF comes in several different strength capsules--0.5 mg, 1 mg and 5 mg. Your transplant team will tell you what dose to take and how often to take it. Your transplant team may adjust your dose until they find what works best for you.
Never change your dose on your own. Never stop taking PROGRAF even if you are feeling well. However, if you feel poorly on Prograf, discuss this with your transplant team.
Take PROGRAF two times a day, 12 hours apart
Try to pick times that will be easy for you. For example, if you take your first dose at 7:00 a.m. you should take your second dose at 7:00 p.m. Do not vary the times. You must take PROGRAF at the same times every day. If you decide to take PROGRAF at 7:00 a.m. and 7:00 p.m., take it at these same times every day. This will make sure you always have enough medicine in your body to give your new organ the around-the-clock protection it needs.
Take PROGRAF the same way each day
Some people prefer to take PROGRAF with food to help reduce possible stomach upset. Whether you take PROGRAF with or without food, it is important to take PROGRAF the same way every day. For example, if you take PROGRAF with food, you should always take it with food. Do not eat grapefruit or drink grapefruit juice in combination with your medicine unless your transplant teams approves. Do not change the way you take this medicine without telling
your transplant team, since this could change the amount of protection you get from PROGRAF.
Take all your doses
It is important to take your doses twice a day exactly as prescribed by your doctor. If you miss even two doses, your new liver or kidney could lose the protection it needs to defend itself against rejection by your body.
If you miss one dose, do not try to catch up on your own. Call your transplant team right away for instructions on what to do.
If you travel and change time zones, be sure to ask your transplant team how to adjust your dosage schedule so your new organ does not lose its protection.
Plan ahead so that you do not run out of PROGRAF
Make sure you have your prescription for PROGRAF refilled and at home before you need it. Circle the date on a calendar when you need to order your refill. Allow extra time if you receive your medicines through the mail.
Your transplant team will follow your progress and watch for early signs of side effects. This is why you will have blood tests done often after your transplant. On the days you are going to have a blood test to measure the amount of PROGRAF in your body, your transplant team may ask you not to take your morning dose until after the blood sample is taken. Check with your transplant team before skipping this dose.
Can Other Medicines Affect How PROGRAF Works?
Some medicines and alcohol can affect how well PROGRAF works. After you start taking PROGRAF:
· Be sure to tell your transplant team, family doctor, dentist, pharmacist and any other health care professional treating you the names of all the medicines you are taking. This includes PROGRAF as well as all other prescription medicines and non- prescription medicines, natural or herbal remedies, nutritional supplements, and vitamins. This is the only way that your health care team can help prevent drug interactions that could be serious.
· Always check with your transplant team before you start taking any new medicine.
· While you are taking PROGRAF, do not get any vaccinations without your transplant team’s approval. The vaccination may not work as well as it should.
· Liver transplant patients, including those taking PROGRAF, should not drink alcohol.
What Are the Possible Side Effects of PROGRAF?
Tell your transplant team right away if you think you might be having a side effect. Your transplant team will decide if it is a medicine side effect or a sign that has nothing to do with the medicine but needs to be treated. Infection or reduced urine can be signs of serious problems that you should discuss with your transplant team.
Your transplant team will also follow your progress and watch for the early signs of any side effects. This is why you will have blood tests done often during the first few months after your transplant. On the days you are going to have a blood test to measure the amount of PROGRAF in your body, your transplant team may ask you not to take your morning dose until after the blood sample is taken. Check skipping this dose.
For Kidney Transplant Patients:
The most common side effects of PROGRAF for kidney transplant patients are infection, headache, tremors (shaking of the body), diarrhea, constipation, nausea, high blood pressure, changes in the amount of urine, and trouble sleeping.
Less common side effects are abdominal pain (stomach pain), numbness or tingling in your hands or feet; loss of appetite; indigestion or "upset stomach"; vomiting; urinary tract infections; fever; pain; swelling of the hands, ankles or legs; shortness of breath or trouble breathing; cough; leg cramps; heart "fluttering", palpitations or chest pain; unusual weakness or tiredness; dizziness; confusion; changes in mood or emotions; itchy skin, skin rash, and diabetes.
For Liver Transplant Patients:
The most common side effects of PROGRAF for liver transplant patients are headache, tremors (shaking of the body), diarrhea, high blood pressure, nausea and changes in the amount of urine.
Less common side effects are numbness or tingling in your hands or feet; trouble sleeping; constipation; loss of appetite; vomiting; urinary tract infections; fever; pain (especially in the back or abdomen [stomach area]); swelling of the hands, ankles, legs or abdomen; shortness of breath or trouble breathing; cough; unusual bruising; leg cramps; heart "fluttering" or palpitations; unusual weakness or tiredness; confusion; changes in mood or emotions; itchy skin, and skin rash.
