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Tacrolimus: Frequently Asked Questions Answered

What is Tacrolimus?

Tacrolimus is a hydrophobic macrocyclic lactone derived from the fermentation of the soil microbe, Streptomyces tsukubaensis. It is an immunosuppressant that belongs to the antibiotic class of macrolides. Despite being structurally different, it is often compared to cyclosporine because of its similar spectrum of immunosuppressive effects. However, Tacrolimus shows a higher in vitro potential of inhibiting autoimmune responses.

What are the uses of Tacrolimus?

Tacrolimus is an immunosuppressive drug employed for external use only, i.e., applied on the skin. The function of this particular type of drug is to decrease immune system activity. It is effective in skin disorders like eczema, vitiligo, connective-tissue disorders, follicular diseases, graft-versus-host disease, and vesiculobullous disorders.

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    What are the side effects of Tacrolimus?

    Typically observed side effects of Tacrolimus are headache, hyperglycemia, infection, nephrotoxicity, diabetes mellitus, hyperkalemia, and increased blood urea nitrogen. There is an increased risk of developing tumors or other adverse infections that might result in hospitalization or even death. Precautions should be taken if symptoms like agitation, seizures, fever, vomiting, tiredness, diarrhea, joint pain, etc., are experienced or observed.

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    Frequently Asked Questions about Tacrolimus

    Often patients who have undergone simultaneous pancreas-kidney transplantation go through Tacrolimus therapy. This might result in an autoimmune disorder called alopecia that involves hair loss. Alopecia is often depicted by a gradual hair loss leading to thinning of hair over the entire scalp. With decreased use of Tacrolimus, the symptoms might be relieved.

    Atopic dermatitis (AD) or eczema is an unpleasant skin disease, and topical corticosteroids have been the principal therapy for the treatment of AD due to their immunomodulatory effects. Tacrolimus is the first steroid-free class of drugs inheriting the same efficiency as corticosteroids to treat AD ranging from moderate to severe disorders.

    If the Tacrolimus level is high, it is characterized by gastroenteritis associated with severe diarrhea. Increased dosages of Tacrolimus are susceptible to nephrotoxicity or kidney damage and tremors or neurotoxicity. Since it weakens the immune responses, the body becomes vulnerable to several bacterial, viral, and fungal infections.

    Despite desirable effects, a drug brings various undesired effects as well. Similarly, itching is a common side effect accompanied by soreness and burning in the treated area of the skin. This might occur in the initial few days of treatment, but it does not require medical attention as a minor side effect.

    Tacrolimus should only be used if and only if a doctor prescribes an individual since it is an immunosuppressant that reduces the activity of the immune system. Initial treatment is often concise, and if it is efficient, it can be used for up to 6-12 months.

    Most of the time, our immune system tends to reject a transplant. The application of Tacrolimus can counter this. The process of preventing rejection is feasible as long as one takes the medication. Tacrolimus weakens the immune system; hence, one should not stop taking Tacrolimus without a doctor's recommendation.

    Previously, steroids have been an effective therapy for eczema because of their immunomodulatory effects. Tacrolimus is the first class of drugs, although devoid of steroids, has similar efficacy to a mid-potency steroid. In comparison to steroids, Tacrolimus does not cause atrophy (skin thinning) or other steroid-related side effects.

    Tacrolimus is a steroid-free anti-inflammatory agent that helps to decrease skin-related inflammatory reactions. It does not cause skin thinning or atrophy, generally caused by steroids. It is prescribed for AD that involves itching, inflammation, and redness, similar to an allergic reaction. Tacrolimus prevents symptoms caused as a result of autoimmunity.

    Tacrolimus being an immunosuppressive drug, is used in chemotherapy to prevent allograft rejection. It inhibits the activity of the immune system by preventing its rejection of an organ transplant by attacking it. It works in multiple ways to hinder the growth of cancer cells. Tacrolimus either obstructs them from proliferating, or impedes them from dividing, or kills them.

    Post-transplant medications such as Tacrolimus might cause dehydration and fluid retention, and these factors might affect body weight in general. Therefore, renal transplant patients should bring lifestyle changes to decrease the chances of excessive weight. Hence, Tacrolimus is usually prescribed along with other medicines to avoid the risk of obesity.