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Astragraf XL is the brand name for tacrolimus and is available as an extended-release capsule.

Astragraf XL is available as a 0.5 mg, 1 mg, or 5 mg extended-release capsule.

Astragraf XL is an immunosuppressant used to prevent organ rejection in kidney transplant patients when used with other immunosuppressants.

Astagraf XL is a calcineurin-inhibitor immunosuppressant. It reduces the activity of your immune system so your body does not reject the transplanted organ.

The typical starting dose of Astagraf XL is 0.1 mg to 0.2 mg/kg of body weight by mouth once a day in the morning. It should be taken every morning at same time on an empty stomach at least 1 hour before a meal or at least 2 hours after a meal.

Astagraf XL is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you have a known hypersensitivity to tacrolimus.

Common side effects of Astagraf XL:

• Tremor
• Diarrhea
• Nausea
• Constipation
• Low red blood cell count
• Swelling in your hands or feet

Serious side effects are rare with Astagraf XL. Contact your healthcare provider immediately if you experience any of the following:

• Abnormal heart rhythm (QT prolongation): chest pounding, trouble breathing, chest pain, feeling faint or lightheaded
• Serious infections: fever, cough, chills, sore throat, runny or stuffy nose, body aches
• Low blood cell counts: bleeding that’s difficult to stop, vomiting blood, blood in the urine or stool, “coffee-ground” stool
• Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
• Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
• Sudden kidney injury: feeling sick or weak, dehydration, urinating less than usual, confusion, blood in urine, swelling in the legs, ankles, or feet
• Nerve problems: seizures, tremors, headache, dizziness, pins sensationAbnormal heart rhythm (QT prolongation): chest pounding, trouble breathing, chest pain, feeling faint or lightheaded
• Serious infections: fever, cough, chills, sore throat, runny or stuffy nose, body aches
• Low blood cell counts: bleeding that’s difficult to stop, vomiting blood, blood in the urine or stool, “coffee-ground” stool
• Heart attack: chest pain, stomach discomfort, sweating, nausea, dizziness
• Stroke: sudden numbness or weakness in the arm, leg, or face, confusion, trouble seeing, headache, difficulty walking
• Sudden kidney injury: feeling sick or weak, dehydration, urinating less than usual, confusion, blood in urine, swelling in the legs, ankles, or feet
• Nerve problems: seizures, tremors, headache, dizziness, pins sensation

The following medications may interact with Astagraf XL:

• Strong CYP3A Inducers like rifampin, rifabutin, phenytoin, carbamazepine, phenobarbital, and St John’s Wort
• Strong CYP3A Inhibitors like nelfinavir, telaprevir, boceprevir, ritonavir, voriconazole, posaconazole, itraconazole,
• Ketoconazole, clarithromycin, and nefazodone
• Magnesium and aluminum hydroxide antacids
• Metoclopramide

Astellas Pharma

It is not known whether this medication is safe for you and your unborn baby during pregnancy. Talk to your doctor if you are already pregnant or if you have plans on becoming pregnant. They will recommend what is best for you.

• Tacrolimus