Advagraf Prolonged-Release Capsules – Tacrolimus for Organ Transplant Immunosuppression | EZ Chemist Online Pharmacy

Advagraf Tacrolimus Prolonged-Release Capsules – Prevent Organ Rejection After Transplant | Buy Online at EZ Chemist
What is Advagraf used for?
Advagraf contains tacrolimus, a once-daily prolonged-release immunosuppressant used to prevent organ rejection in kidney and liver transplant recipients. It works by suppressing T-cell activation and modulating the immune response to reduce the risk of transplant rejection.
Brand Name: Advagraf

Generic Name: Tacrolimus (as monohydrate)

Form: Prolonged-release capsules

Strengths Available: 0.5 mg, 1 mg, 3 mg, 5 mg

Dosage Form: Oral Capsules

Drug Class: Calcineurin Inhibitor Immunosuppressant

Schedule: Prescription-only medication (Rx)

Manufacturer: Astellas Pharma Europe Ltd

Availability in India: Buy Advagraf Online – EZ Chemist
Tacrolimus Monohydrate (Prolonged-Release)
Each capsule contains tacrolimus in a formulation designed for once-daily administration, maintaining consistent blood levels for improved graft protection and reduced variability.

Other Popular and Common Names:
Generic: Tacrolimus

Immediate-release Brands: Prograf, Tacroz

Other Extended-release Brands: Envarsus XR (alternate prolonged-release brand)

Therapeutic Category: Immunosuppressant, Calcineurin Inhibitor
Tacrolimus binds to FK506-binding protein 12 (FKBP-12), forming a complex that inhibits calcineurin, a phosphatase necessary for activating T-cell transcription factors like NFAT. This leads to suppressed interleukin-2 (IL-2) production and inhibited T-lymphocyte activation, reducing immune-mediated organ rejection.

Clinical Study Reference:
NEJM (1994) and Lancet (2003) confirm that tacrolimus is significantly more effective than cyclosporine in preventing acute rejection in kidney and liver transplant patients.
Prophylaxis of organ rejection in kidney and liver transplant recipients

Conversion from immediate-release tacrolimus in stable patients requiring once-daily dosing

Treatment of allograft rejection unresponsive to other immunosuppressants (off-label)
Indication Starting Dose Route Notes
Kidney Transplant 0.2–0.3 mg/kg/day Oral Administer once daily in the morning, on an empty stomach
Liver Transplant 0.1–0.2 mg/kg/day Oral May be adjusted per trough blood levels
Target Blood Level 5–15 ng/mL Measured via whole blood trough levels

Do not chew/crush. Swallow capsule whole with water.
Dose individualised based on trough blood levels and patient response.
Pregnancy Category: C – Use only if benefits outweigh risks

Pediatric Use: Limited data for prolonged-release form

Geriatric Use: Use with caution due to increased susceptibility to infections

Liver/Renal Impairment: May require dose adjustment; monitor closely

Safety Information:
Common Side Effects:
Tremors

Headache

Insomnia

Nausea

Diarrhoea

Hypertension
Nephrotoxicity (dose-dependent)
Neurotoxicity (seizures, confusion)
New-onset diabetes after transplantation (NODAT)
Infections (CMV, BK virus)

Increased risk of malignancies (lymphoma, skin cancer)

Monitoring Required:

Blood tacrolimus levels

Serum creatinine and electrolytes

Blood glucose and liver function

Complete blood count (CBC)
Therapeutic drug monitoring (TDM) is essential to avoid under- or overdosing.

Avoid grapefruit or grapefruit juice, which increases tacrolimus blood levels.

Increased susceptibility to opportunistic infections and lymphoma.

Avoid live vaccines during therapy.

Use caution with concurrent nephrotoxic or neurotoxic drugs.
Increased Tacrolimus Levels With:

Azole antifungals (ketoconazole, itraconazole)
Macrolide antibiotics (clarithromycin, erythromycin)
Protease inhibitors (ritonavir)
Decreased Tacrolimus Levels With:
Rifampicin
Phenytoin
St John’s Wort (contraindicated)

Additive Nephrotoxicity With:

NSAIDs

Aminoglycosides

Amphotericin B

Clinical Evidence:
Studies in Transplantation Proceedings (2009) show significant interindividual variability in tacrolimus exposure due to CYP3A4/5 polymorphisms and drug interactions, underlining the importance of blood level monitoring.
Store at below 25°C, protect from moisture and light

Do not use after the expiry date

Keep out of reach of children

Frequently Asked Questions (FAQs):
Q1: What is Advagraf used for?
Advagraf is used to prevent organ transplant rejection, especially after kidney and liver transplants.

Q2: What is the difference between Advagraf and Prograf?
Advagraf is a prolonged-release version taken once daily, while Prograf is an immediate-release formulation taken twice daily.

Q3: Can Advagraf be taken with food?
Take on an empty stomach, ideally the same way every day to maintain consistent absorption.

Q4: What happens if I miss a dose?
Take the missed dose as soon as possible unless it is close to your next dose. Do not double the dose. Inform your doctor.

Q5: Is Advagraf safe during pregnancy or breastfeeding?
Advagraf should only be used in pregnancy if essential. It is excreted in breast milk, and breastfeeding is not recommended.

Q6: How is the dose of Advagraf adjusted?
Based on tacrolimus blood levels, renal function, and response to therapy. Routine monitoring is critical.

Clinical References:
Pillans P. et al. – Tacrolimus pharmacokinetics and clinical outcomes in transplant patients (Transplantation Reviews, 2006)

FDA Prescribing Information – Advagraf
Astellas Product Monograph
Kahan BD. – Immunosuppressive therapy in transplantation: strategies and risks (NEJM, 2003)
ClinicalTrials.gov – Studies on once-daily tacrolimus pharmacodynamics
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