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Prograf uses, dosage imuran and its metabolite 6-mercaptopurine 6-mp .

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The relative risks of toxicity and efficacy failure are related to tacrolimus whole blood trough concentrationsThereforemonitoring of whole blood trough concentrations is recommended to assist in the clinical evaluation of toxicity and efficacy failure.

Pediatric liver transplantation patients without pre-existing renal or hepatic dysfunction have required and tolerated higher doses than adults to achieve similar blood concentrations.

Tacrolimus is available in different formulationssuch as immediate and extended-releaseDo not switch between different forms of tacrolimus without consulting your doctor.

Prograf was approved for use in Canada in December 19955 It is indicated for the prevention of organ rejection in patients who have received allogeneic liverkidneyor heart transplant and for the treatment of refractory rejection in patients who have received allogeneic liver or kidney transplantsas well as for treating some cases of rheumatoid arthritis in adults6 Advagraf was approved for use in Canada in October 2007 5 and was made available on the market in April 20087 It is indicated for the prevention of organ rejection in adult patients who have received allogeneic kidney transplant8 Both Prograf and Advagraf contain the immunosuppressant tacrolimushoweverPrograf is an immediate-release formulation to be taken every 12 hours when used for the prevention of organ rejectionwhereas Advagraf is an extended-release formulation that is to be taken every 24 hours68 Tacrolimus has a narrow therapeutic index and highly variable pharmacokineticsit requires individualized dosing based on the results of careful therapeutic monitoringIt is imperative that Prograf and Advagraf be prescribeddispensedand taken correctly to ensure that blood levels of tacrolimus are maintained within the therapeutic range68.

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