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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:Sandoz Inc
Route:ORAL
Strength:5 mg in 1 1
Approved: 2019/06/20
NDC:0781-2104
HYALURONIC ACID SODIUM SALT 1% / TACROLIMUS 0.1% / UREA 20%
Manufacturer:Sincerus Florida, LLC
Route:TOPICAL
Strength:0.1 g in 100 g
Approved: 2019/05/16
NDC:72934-2097
tacrolimus
Manufacturer:Glenmark Pharmaceuticals Inc., USA
Route:ORAL
Strength:0.5 mg in 1 1
Approved: 2023/10/17
NDC:68462-685
Envarsus XR
Manufacturer:Veloxis Pharmaceuticals, Inc
Route:ORAL
Strength:1 mg in 1 1
Approved: 2023/07/26
NDC:68992-3010
Tacrolimus
Manufacturer:CONCORD BIOTECH LIMITED
Route:ORAL
Strength:5 mg in 1 1
Approved: 2023/11/10
NDC:68254-5006

Singapore Approved Products

PROTOPIC OINTMENT 0.1%
Manufacturer:LEO Laboratories Limited
Form:OINTMENT
Strength:0.10g/100g
Online:Yes
Approved: 2004/03/08
Approval:SIN12524P
Advagraf Prolonged Release Hard Capsules 1 mg
Manufacturer:Astellas Ireland Co., Ltd, Astellas Pharma Inc. Toyama Technology Center (Intermediate Granules)
Form:CAPSULE, EXTENDED RELEASE
Strength:1.0 mg
Online:Yes
Approved: 2012/04/16
Approval:SIN14134P
TACROLIMUS–TEVA PROLONGED RELEASE HARD CAPSULE 1MG
Manufacturer:Teva Pharmaceutical Works Private Limited Company
Form:CAPSULE, EXTENDED RELEASE
Strength:1.0 mg
Online:Yes
Approved: 2021/04/21
Approval:SIN16161P
SALVADO 0.5 CAPSULE 0.5MG
Manufacturer:Biocon Pharma Limited, Biocon Limited (Drug Product Intermediate)
Form:CAPSULE
Strength:0.5mg
Online:Yes
Approved: 2022/03/30
Approval:SIN16457P
TACROCIN 0.5- TACROLIMUS CAPSULE USP 0.5 MG
Manufacturer:Intas Pharmaceuticals Limited, Concord Biotech Limited (DP Intermediate)
Form:CAPSULE, GELATIN COATED
Strength:0.5 mg
Online:Yes
Approved: 2021/04/21
Approval:SIN16159P

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