Prograf is an "immunosuppressant" or 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.

Prograf is easy to swallow because the capsules are small. This can make a big difference if you have trouble swallowing pills and need to take a lot of medication every day.

Prograf has no unpleasant taste or odor.

WARNING

Increased susceptibility to infection and the possible development of lymphoma may result from immunosuppression. Only physicians experienced in immunosuppressive therapy and management of organ transplant patients should prescribe Prograf. Patients receiving the drug should be managed in facilities equipped and staffed with adequate laboratory and supportive medical resources. The physician responsible for maintenance therapy should have complete information requisite for the follow-up of the patient.

• 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 AM you should take your second dose at 7:00 PM. Do not vary the times. You must take PROGRAF at the same times every day. If you decide to take PROGRAF at 7:00 AM and 7:00 PM, 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 team 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 with your transplant team before 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.

Be sure to tell your transplant team right away if you notice that you are thirstier than usual, have to urinate more often, have blurred vision or seem to get confused. These may be the early signs of high blood sugar or diabetes.

All anti-rejection medicines, including PROGRAF, suppress your body's immune system. As a result, they may increase your chances of getting infections and some kinds of cancer, including skin and lymph gland cancer (lymphoma). As usual for patients with increased risk for skin cancer, exposure to sunlight and UV light should be limited by wearing protective clothing and using a sunscreen with a high sun protection factor (SPF>15). However, getting cancer from taking an anti-rejection medicine is not common. Talk with your transplant team about any concerns or questions you have.

How Should I Store PROGRAF?
Store PROGRAF in a dry area at room temperature (77°F/25°C). Do not let the medicine get colder than 59°F (15°C) or hotter than 86°F (30°C). For instance, do not leave PROGRAF in the glove compartment of your car in the summer or winter. Do not keep PROGRAF capsules in a hot or moist place such as the medicine cabinet in the bathroom.

General Advice about Prescription Medicines
Medicines are sometimes prescribed for conditions that are not mentioned in patient information leaflets. Do not use PROGRAF for a condition for which it was not prescribed. Do not give PROGRAF to other people.

Note: This information is strictly for educational purposes and should not substitute for the opinion of a doctor.
Norphar offers Prograf from Canada priced in American dollars for people whose insurance covers prescription medication from Canada i.e. United Healthcare. Our service is also for people in the U.S. that are uninsured or on Medicare that are underinsured for prescription medication. The prices and terms set forth on this page are subject to change without notice. Please consult a Norphar representative for specific prices and terms for each medication.