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Tacrolimus

Generic Name
Tacrolimus
Brand Names
Advagraf, Astagraf, Envarsus, Modigraf, Prograf, Protopic, Tacforius
Drug Type
Small Molecule
Chemical Formula
C44H69NO12
CAS Number
104987-11-3
Unique Ingredient Identifier
Y5L2157C4J

Overview

Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants, and the skin condition vitiligo. It was discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. Tacrolimus is chemically known as a macrolide. It reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex inhibits calcineurin which inhibits T-lymphocyte signal transduction and IL-2 transcription.

Background

Tacrolimus (also FK-506 or Fujimycin) is an immunosuppressive drug whose main use is after organ transplant to reduce the activity of the patient's immune system and so the risk of organ rejection. It is also used in a topical preparation in the treatment of severe atopic dermatitis, severe refractory uveitis after bone marrow transplants, and the skin condition vitiligo. It was discovered in 1984 from the fermentation broth of a Japanese soil sample that contained the bacteria Streptomyces tsukubaensis. Tacrolimus is chemically known as a macrolide. It reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 (FK506 binding protein) creating a new complex. This FKBP12-FK506 complex inhibits calcineurin which inhibits T-lymphocyte signal transduction and IL-2 transcription.

Indication

Immediate-release formulations of tacrolimus are indicated for the prophylaxis of organ rejection in adult and pediatric patients receiving allogeneic liver, kidney, heart, or lung transplants, in combination with other immunosuppressants. Extended-release formulations of tacrolimus are indicated for the prophylaxis of organ rejection in adult and pediatric patients receiving kidney transplants, in combination with other immunosuppressants, and may be used in patients converted from immediate-release formulations. Topical tacrolimus ointment is indicated as second-line therapy for short-term and non-continuous treatment of moderate-to-severe atopic dermatitis in non-immunocompromised adults and children who have failed to respond adequately to other topical treatments or for whom alternative treatments are not advisable. Both available strengths are indicated in adult patients, while only the lower strength (0.03%) formulation is indicated in pediatric patients between 2 and 15 years of age.

Associated Conditions

  • Graft-versus-host Disease (GVHD)
  • Heart Transplant Rejection
  • Kidney Transplant Rejection
  • Liver Transplant Rejection
  • Lung Transplant Rejection
  • Oral Lichen Planus
  • Psoriasis
  • Pyoderma Gangrenosum
  • Rheumatoid Arthritis
  • Severe Atopic Dermatitis
  • Vitiligo
  • Moderate Atopic dermatitis

FDA Approved Products

Tacrolimus
Manufacturer:Bryant Ranch Prepack
Route:ORAL
Strength:1 mg in 1 1
Approved: 2019/06/20
NDC:63629-8723
Tacrolimus
Manufacturer:Quallent Pharmaceuticals Health LLC
Route:ORAL
Strength:1 mg in 1 1
Approved: 2019/06/19
NDC:82009-054
tacrolimus
Manufacturer:Chengdu Suncadia Medicine Co., Ltd.
Route:ORAL
Strength:1 mg in 1 1
Approved: 2024/02/07
NDC:71432-2002
ASTAGRAF XL
Manufacturer:Astellas Pharma US, Inc.
Route:ORAL
Strength:5 mg in 1 1
Approved: 2020/12/01
NDC:0469-0687
Tacrolimus
Manufacturer:Cardinal Health 107, LLC
Route:ORAL
Strength:1 mg in 1 1
Approved: 2021/07/19
NDC:55154-4080

Singapore Approved Products

TACROCIN 5- TACROLIMUS CAPSULE USP 5 MG
Manufacturer:Intas Pharmaceuticals Limited, Concord Biotech Limited (DP Intermediate)
Form:CAPSULE, GELATIN COATED
Strength:5 mg
Online:Yes
Approved: 2021/04/21
Approval:SIN16157P
TACROCIN 1- TACROLIMUS CAPSULE USP 1 MG
Manufacturer:Intas Pharmaceuticals Limited, Concord Biotech Limited (DP Intermediate)
Form:CAPSULE, GELATIN COATED
Strength:1 mg
Online:Yes
Approved: 2021/04/21
Approval:SIN16158P
TACROLIMUS–TEVA PROLONGED RELEASE HARD CAPSULE 5MG
Manufacturer:Teva Pharmaceutical Works Private Limited Company
Form:CAPSULE, EXTENDED RELEASE
Strength:5.0 mg
Online:Yes
Approved: 2021/04/21
Approval:SIN16160P
Advagraf Prolonged Release Hard Capsules 0.5 mg
Manufacturer:Astellas Ireland Co., Ltd, Astellas Pharma Inc. Toyama Technology Center (Intermediate Granules)
Form:CAPSULE, EXTENDED RELEASE
Strength:0.5 mg
Online:Yes
Approved: 2012/04/16
Approval:SIN14133P
TACROLIMUS SANDOZ CAPSULE 0.5 MG
Manufacturer:Sandoz Private Limited
Form:CAPSULE, GELATIN COATED
Strength:0.5 mg
Online:Yes
Approved: 2019/04/25
Approval:SIN15673P

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