Question 1

How can I lower the cost of my tacrolimus

Accepted Answer

You can lower cost of your tacrolimus using one of the 4 following drug savings programs: Rx Advantage Card for tacrolimus, Canadian Prescription Savings for tacrolimus, tacrolimus Drug Coupons, tacrolimus Patient Assistance Programs

Question 2

What dosages is tacrolimus available in?

Accepted Answer

tacrolimus is available as 0.5 mg, 1 mg, and 5 mg oral capsule and 0.2 mg and 1 mg granules for oral suspension,

Question 3

What is tacrolimus used for?

Accepted Answer

tacrolimus is a calcineurin inhibitor that is used for the prevention of organ transplant rejection, including:  Kidney transplant Liver or heart transplant – generic tacrolimus capsule and brand tacrolimus only Lung transplant – brand tacrolimus only

Question 4

How does tacrolimus work?

Accepted Answer

tacrolimus is a calcineurin inhibitor. It works as an immunosuppressant, which lowers the activity of your immune system. You need a weakened immune system after receiving an organ transplant so your body doesn’t reject the new organ.

Question 5

How do I take tacrolimus?

Accepted Answer

Your provider will determine your dose of tacrolimus based on your weight, ethnicity, kidney or liver health, the type of transplant you received, and the other immunosuppressants you’re taking. It is typically taken by mouth twice daily.

Question 6

Is it safe for me to take tacrolimus?

Accepted Answer

tacrolimus 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 hypersensitivity to tacrolimus or HCO-60 (polyoxyl 60 hydrogenated
castor oil).

Question 7

tacrolimus Common Side Effects

Accepted Answer

Common side effects of tacrolimus:  Tremor High blood pressure Changes in electrolyte levels Infections Higher creatinine levels Headache Diarrhea Nause Swelling of hands and feet Constipation Feeling weak General pain Trouble sleeping Low red blood cell count

Question 8

tacrolimus Serious Side Effects

Accepted Answer

Serious side effects are rare with tacrolimus. 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 sensation

Question 9

Effects of other drugs, drug classes and over-the-counter products on tacrolimus

Accepted Answer

The following medications may interact with tacrolimus:  Mycophenolic Acid Products: Can increase MPA exposure after crossover from cyclosporine to tacrolimus; monitor for MPA-related adverse reactions and adjust MMF or MPA dose as needed Nelfinavir and Grapefruit Juice: Increased tacrolimus concentrations via CYP3A inhibition; avoid concomitant use CYP3A Inhibitors: Increased tacrolimus concentrations; monitor concentrations and adjust tacrolimus dose as needed CYP3A4 Inducers: Decreased tacrolimus concentrations; monitor concentrations and adjust tacrolimus dose as needed Therapeutic drug monitoring and dose reduction for tacrolimus should be considered when tacrolimus is co-administered with cannabidiol

Question 10

Who makes tacrolimus?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is tacrolimus safe in pregnancy?

Accepted Answer

tacrolimus can cause fetal harm when administered to a pregnant woman. There is a pregnancy registry that monitors pregnancy outcomes in women exposed to tacrolimus during pregnancy. The Transplantation Pregnancy Registry International (TPRI) is a voluntary pregnancy exposure registry that monitors outcomes of pregnancy in female transplant recipients and those fathered by male transplant recipients exposed to immunosuppressants including tacrolimus. Healthcare providers are encouraged to advise their patients to register by contacting the Transplantation Pregnancy Registry International at 1-877-955-6877 or
Transplant pregnancy registry

Question 12

What is the brand name for tacrolimus?

Accepted Answer

PROGRAFPROTOPIC

Question 13

How can NowPatient help me to lower the cost of my tacrolimus prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your tacrolimus prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient tacrolimus savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient tacrolimus savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for tacrolimus	Canadian Prescription Savings* for tacrolimus	tacrolimus Drug Coupon*	tacrolimus Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of tacrolimus?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for tacrolimus	Canadian Prescription Savings* for tacrolimus	tacrolimus Drug Coupon*	tacrolimus Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the tacrolimus savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the tacrolimus drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for tacrolimus, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the tacrolimus prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, tacrolimus is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed tacrolimus for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the tacrolimus prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the tacrolimus prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for tacrolimus

If you are having trouble paying for your tacrolimus medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for tacrolimus you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
tacrolimus is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers tacrolimus
If tacrolimus is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for tacrolimus

If you are having trouble paying for your tacrolimus medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for tacrolimus you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers tacrolimus
If tacrolimus is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for tacrolimus

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your tacrolimus treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for tacrolimus you will need to meet the following criteria:

You must be currently insured and have coverage for tacrolimus
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.