Primary immunosuppression in liver and kidney allograft recipients; Liver and kidney allograft rejection resistant to conventional immunosuppressive regimens; eczema [as ointment].
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It is a macrolide that reduces peptidyl-prolyl isomerase activity by binding to the immunophilin FKBP-12 [FK506 binding protein] creating a new complex. This FKBP12- FK506 complex interacts with and inhibits cal- cineurin thus inhibiting both T-lymphocyte signal transduction and IL-2 transcription. Although this activity is similar to cyclosporin, studies have shown that the incidence of acute rejection is reduced by tacrolimus use over ciclosporin.
Vaccinations; blood level monitoring is recommended during the early post- transplantation period.
Hypertension; tremor, headache, insomnia, perception or visual disorder, abnormal kidney function, constipation, diarrhoea, nausea, hypercalcaemia, hyperglycaemia, hypophosphataemia, leucocytosis. Less frequently angina pectoris, tachycardia, depression, neuropathy, nervousness, vomiting, abnormal liver function test, diabetes mellitus, cramps, impairment of lung function, alopecia, pruritus, leucopenia, anaemia, oedema in various organ systems.
Live attenuated vaccines, clotrimazole, danazol, dexamethasone, methylprednisolone