Published: March 2013

Tacrolimus - Check the Brand

Prescriber Update 34(1):4
March 2013

Key Messages

  • To reduce the potential for error, tacrolimus should be prescribed with a full description of the drug and the brand.
  • If the brand, strength and dose frequency are not clearly stated on the prescription, the dispensing pharmacist should check with the prescriber to ensure the appropriate medicine is dispensed.
  • Switching between brands of tacrolimus requires careful therapeutic monitoring under the supervision of a transplant specialist.

With the introduction of generic versions of tacrolimus in New Zealand, healthcare professionals are reminded that different brands of this medicine are not readily interchangeable.

Tacrolimus is known to have a narrow therapeutic range, meaning small changes in plasma concentration can increase the risk of the patient experiencing a clinically significant event.

Although the two tacrolimus medicines available in New Zealand (Sandoz and Prograf) have been demonstrated to be bioequivalent, switching between brands should only be completed under specialist supervision. Therapeutic monitoring is recommended under specialist supervision to minimise the risk of adverse reactions or graft rejection.

Patients can play their part in reducing potential problems also. To prevent confusion, patients should take note of the name of their tacrolimus medicine and if unsure, check this with their doctor of pharmacist. If it is necessary to change the tacrolimus medicine a patient is taking, this should be fully discussed with the patient.