| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| TACROLIMUS (Paeds) (Advagraf, FK506, Prograf) Mechanism of action: Immune suppressant; calcineurin inhibitor Ref: 4, 44, 114, 478, 560, 561 Last update: 2022-09-13 |
Prograf capsule: 0.5 mg, 1 mg, 5 mg. Sandoz capsule: 0.5 mg, 1 mg, 5 mg. Advagraf capsule (extended-release): 0.5 mg, 1 mg, 3 mg, 5 mg (not all available strengths stocked at BCCH). injection: 5 mg/1 mL amp. |
Children: Initial oral dose of immediate-release: 0.05-0.2 mg/kg/dose PO Q12H and titrate to target trough level For conversion to extended-release tacrolimus: sum total milligrams of Q12H dosing per 24 hours and dose as ONCE daily (1:1 ratio) IV: 0.01-0.06 mg/kg/dose via continuous IV infusion or divided Q12H GVHD Prophylaxis for HSCT 0.015 mg/kg/dose IV Q12H or 0.03 mg/kg/24H via continuous IV infusion Switching from IV to PO: Solid organ transplant: Multiply IV dose x3 HSCT: Multiply IV dose x 4 |
First oral dose is usually given 8-12 hours after IV infusion is discontinued. Many potential drug interactions; consult pharmacist. Target therapeutic range varies according to transplant type and time post-transplant. Refer to Therapeutic Drug Monitoring Table in References and Supplementary (white pages in print copy). Serum levels of tacrolimus given orally may be increased approximately 2 fold when patient has diarrhea. Oral suspension administration via feeding tubes may result in variable levels. Advagraf is an extended release capsule formulation give ONCE daily. Swallow whole, do not crush, chew, or break. Standard Prescription: tacrolimus__mg PO{IV} Q__H (__mg/kg/24hr) tacrolimus__mg IV infusion over__hours (__mg/kg/24hr) Q__H |