About this leaflet

This information leaflet has been written to help you to understand more about your Tacrolimus medication and to help answer some of your questions. We also recommend you read the information leaflet enclosed with your medication for more detail.

What is Tacrolimus and why am I taking it?

Tacrolimus is an oral medication that belongs to a group of medicines called immunosuppressants. These medicines help to calm down your immune system when it becomes overactive.

You have been prescribed Tacrolimus to manage inflammation caused by your immune system, often as a side effect of immunotherapy treatment. It may be used on its own or alongside other medications to help control symptoms and prevent further damage.

How do I take Tacrolimus?

  • Take Tacrolimus by mouth as a tablet.
  • Take it on an empty stomach, 1 hour before food.
  • Avoid grapefruit or grapefruit juice – it can interfere with how your body absorbs the medication.
  • Take your doses 12 hours apart (e.g. at 10am and 10pm).
  • Your dose may be adjusted based on blood test results.

Monitoring while on Tacrolimus

  • You’ll need regular blood tests to check the amount of Tacrolimus in your blood.
  • Do not take your morning dose before your blood test – bring it with you and take it after the test.
  • Ideally, your last dose should be 12 hours before your blood test.
  • This helps your healthcare team make sure the medicine is working safely and effectively

Do not stop taking Tacrolimus unless told to by your healthcare team.

If you run low or need a new prescription, please contact your healthcare team. Your GP may not be able to prescribe Tacrolimus.

If you need more Tacrolimus, please contact your healthcare team to arrange a new prescription. If you have any difficulties getting your medication, please call The Clatterbridge Cancer Centre's 24-hour Patient Hotline on 0800 169 5555 for support and advice.

Are there any possible side effects to Tacrolimus?

Like all medications, Tacrolimus can cause side effects, although not everyone will experience them.

Common side effects may include:

  • Feeling tired or fatigued
  • Mouth sores, ulcers, or white spots

More side effects – You should contact your healthcare team for advice if you experience any of the following:

  • Nausea, vomiting, or diarrhoea
  • Headaches
  • Signs of infection (fever, chills, sore throat)
  • Easy bruising or unexplained bleeding

For full details on possible side effects, please refer to the manufacturer's patient information leaflet provided with your medication.

Important information about taking Tacrolimus

If you feel unwell at any time while taking Tacrolimus, please contact The Clatterbridge Cancer Centre's 24-hour Patient Hotline on 0800 169 5555 for support and advice.

Vaccination advice

While taking Tacrolimus, you can safely receive the following recommended vaccines:

  • Flu vaccine
  • COVID-19 vaccine
  • Pneumococcal vaccine

These vaccines help protect you from serious infections and are recommended during your treatment.

However, you should avoid live vaccines, as these may not be safe while your immune system is suppressed. Live vaccines can include but are not limited to:

  • BCG Vaccine
  • Measles, Mumps and Rubella (MMR) vaccine (Priorix, MMRVaxPro)
  • Rotavirus vaccine (Rotarix)
  • Shingles vaccine (Zostavax)
  • Oral typhoid vaccine (Ty21a)
  • Varicella vaccine (Varilrix and Varilvax)
  • Yellow fever vaccine

If you are offered any vaccine, it is important to inform the vaccinator that you are taking Tacrolimus, so they can ensure the vaccine is suitable for you.

Pregnancy and fertility

Tacrolimus is not recommended if you are pregnant, planning a pregnancy, or breastfeeding. If any of these apply to you, please speak to your healthcare team before starting or continuing this medication.

If you are sexually active, it is important to use effective contraception (e.g. condoms) while taking Tacrolimus to avoid becoming pregnant during treatment.

Things to remember while taking Tacrolimus

  • Take Tacrolimus 12 hours apart, on an empty stomach.
  • Don’t take it with grapefruit.
  • Don’t take your morning dose before a blood test – bring it with you.
  • Keep up with regular blood tests.
  • Don’t stop the medication unless advised by your healthcare team.
  • Use contraception and discuss pregnancy or breastfeeding plans with your team.
  • Stay up to date with vaccines – but avoid live ones. If you are unsure – check with your vaccinator.
  • Store Tacrolimus safely – keep it out of sight and reach of children.

If you feel unwell or have concerns, call the 24-hour Patient Hotline: 0800 169 5555.

Cancer Voices logo

This information has been reviewed by Cheshire and Merseyside Cancer Voices to check it is easy to understand. Cheshire and Merseyside Cancer Voices is a panel of cancer patients who volunteer to read NHS information to make sure it makes sense to people. They have been brought together by Cheshire and Merseyside Cancer Alliance.