Tacrolimus (Prograf)
Calcineurin inhibitor immunosuppressant, more commonly used in modern organ transplantation than cyclosporine. CYP3A4/5 and P-glycoprotein substrate. Extremely narrow therapeutic window requiring individualized dosing based on CYP3A polymorphisms.
Projected serum levels — 3 mg, twice daily
Maintenance schedule: 3 mg twice daily (oral).
Loading schedule: 9 mg on day 1, then 3 mg twice daily — reaching therapeutic levels sooner.
Modeled steady state after ~3 days: peak ≈ 1.8 mg, trough ≈ 1.4 mg body load. Population-based estimate over 15 days for a 3 mg dose at a 70 kg reference body mass — the interactive app scales curves to your doses, timing, and body mass.
Key facts
- Category
- Immunosuppressant
- Route modeled
- Oral
- Model confidence
- predicted
- Half-life
- 12 h
- Common dose
- 3 mg
- Suggested maximum
- 20 mg/day
- Reference dose range
- 1.5–20 mg (single dose)
- Suggested cadence
- twice daily
- Validated against
- 5 mg oral — Cmax 0.030 mg/L at 2 h
Documented interactions
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danger
Apigenin + Tacrolimus (Prograf)
Apigenin may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration changes can…
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danger
Aripiprazole (Abilify) + Tacrolimus (Prograf)
Aripiprazole (Abilify) may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration…
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danger
Astaxanthin + Tacrolimus (Prograf)
Astaxanthin may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration changes can…
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danger
Atomoxetine (Strattera) + Tacrolimus (Prograf)
Atomoxetine (Strattera) may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration…
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danger
Atorvastatin (Lipitor) + Tacrolimus (Prograf)
Atorvastatin (Lipitor) may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic index; free concentration…
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danger
Black Seed Oil (Nigella sativa / Thymoquinone) + Tacrolimus (Prograf)
Black Seed Oil (Nigella sativa / Thymoquinone) may displace Tacrolimus (Prograf) from plasma protein binding sites, transiently raising free drug concentration. This drug has a narrow therapeutic…
Serum checks 202 modeled interaction pairings for tacrolimus (prograf) across your whole stack — absorption conflicts, enzyme inhibition, and nutrient depletion included.
Research behind this entry
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Tacrolimus, why pharmacokinetics matter in the clinic
Clinical pharmacokinetics review with CYP3A dosing implications.
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CYP3A-status is associated with blood concentration and dose-requirement of tacrolimus in heart transplant recipients
CYP3A4*22 polymorphism affects tacrolimus levels and dosing.
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Effects of St. John's Wort (Hypericum perforatum) on Tacrolimus Pharmacokinetics in Healthy Volunteers
St. John's wort induces tacrolimus metabolism; 57.8% AUC decrease.
3 published studies referenced in the app, each with a plain-language summary.